Early-onset neonatal sepsis is associated with an increased likelihood of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), although the association with ADHD is attenuated in sibling-matched analyses, according to a study published online June 18 in Paediatric and Perinatal Epidemiology.
Mads Andersen, from Aarhus University Hospital in Denmark, and colleagues examined the association between early-onset neonatal infection and ADHD and ASD in a nationwide register-based cohort study involving near-term and term children born between 1997 and 2013, with follow-up to 2021. An early-onset infection was defined as an invasive bacterial infection occurring within the first week of life.
A total of 981,869 children were included in the study: 8,154 had sepsis and 152 had meningitis. Of these, only 257 and 32 had culture-positive sepsis and culture-positive meningitis, respectively. The researchers found that for children with sepsis, the incidence rate of ADHD and ASD was 4.5 and 3.3 per 1,000 person-years, respectively. There was an association seen for sepsis with increased adjusted likelihood of ADHD and ASD (hazard ratios [95% confidence intervals], 1.28 [1.17 to 1.39] and 1.43 [1.30 to 1.58], respectively).
The association with ADHD was attenuated in sibling-matched analyses (hazard ratio, 1.12; 95% confidence interval, 0.93 to 1.34). An association was also found between children with meningitis and increased likelihood of ADHD and ASD (incidence rate ratios [95% confidence intervals], 1.77 [0.88 to 3.17] and 2.05 [0.89 to 4.04], respectively).
“Preventive measures directed towards bacterial infections in the first week of life may therefore not only reduce the immediate morbidity and mortality related to the infection, but also the long-term likelihood of ASD,” the authors write. “However, such preventive strategies may not reduce the likelihood of ADHD.”
More information:
Mads Andersen et al, Early‐Onset Neonatal Infection and Attention Deficit Hyperactivity and Autism Spectrum Disorder: A Nationwide Cohort Study, Paediatric and Perinatal Epidemiology (2025). DOI: 10.1111/ppe.70036
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Onset of sepsis in first week of life tied to increased likelihood of autism spectrum disorder (2025, June 24)
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