TY - JOUR
T1 - Risk of psychiatric neurodevelopmental disorders after meningitis in childhood
T2 - a nationwide, population-based cohort study
AU - Graham, Emma E
AU - Tetens, Malte Mose
AU - Bodilsen, Jacob
AU - Dessau, Ram
AU - Ellermann-Eriksen, Svend
AU - Andersen, Nanna S.
AU - Jørgensen, Charlotte Sværke
AU - Pedersen, Michael
AU - Søgaard, Kirstine Kobberøe
AU - Bangsborg, Jette M.
AU - Nielsen, Alex Christian
AU - Møller, Jens Kjølseth
AU - Obel, Dorrit
AU - Lebech, Anne Mette
AU - Nygaard, Ulrikka
AU - Omland, Lars Haukali
AU - Obel, Niels
PY - 2025/1
Y1 - 2025/1
N2 - BACKGROUND: Few studies have investigated the risk of psychiatric neurodevelopmental disorders (PNDD) after childhood meningitis.METHODS: Nationwide population-based cohort study (Denmark, 1995-2021) of children with positive cerebrospinal fluid for bacteria or enterovirus, stratified on age as young infants (0 to <90 days, n = 637) or older children (≥90 days to <17 years, n = 1,218). We constructed a comparison cohort from the general population (n = 18,550), and cohorts of siblings of participants. As risk estimates of PNDD we calculated age- and sex-adjusted hazard ratios (aHRs) with 95% confidence intervals (95%CI).RESULTS: Children with bacterial meningitis had increased risks of PNDD, especially learning and intellectual developmental disorders (young infants: aHR 4.2, 95%CI: 2.4-7.1; older children: aHR 1.5, 95%CI: 1.0-2.3), attention deficit disorder (ADHD) (young infants: aHR 2.8, 95%CI: 1.5-5.2; older children: 1.4, 95%CI: 0.9-2.2) and redemption of ADHD medication (young infants: aHR 2.2, 95%CI: 1.0-4.7; older children: 1.5, 95%CI: 1.0-2.3). Young infants with bacterial meningitis additionally had increased risks of autism spectrum disorders (aHR 1.9, 95%CI: 0.9-4.1) and behavioural and emotional disorders (aHR 2.0, 95%CI: 1.0-3.9). In young infants, the excess risk of PNDD was especially observed in premature children. Siblings of older children with bacterial meningitis also had increased risks of PNDD. Children with enteroviral meningitis at any age did not have increased risks of PNDD or redemption of ADHD medication.CONCLUSIONS: Bacterial meningitis in childhood is associated with subsequent diagnosis of PNDD, while enteroviral meningitis is not. The association appears to be partly explained by prematurity and familial and socioeconomic factors.
AB - BACKGROUND: Few studies have investigated the risk of psychiatric neurodevelopmental disorders (PNDD) after childhood meningitis.METHODS: Nationwide population-based cohort study (Denmark, 1995-2021) of children with positive cerebrospinal fluid for bacteria or enterovirus, stratified on age as young infants (0 to <90 days, n = 637) or older children (≥90 days to <17 years, n = 1,218). We constructed a comparison cohort from the general population (n = 18,550), and cohorts of siblings of participants. As risk estimates of PNDD we calculated age- and sex-adjusted hazard ratios (aHRs) with 95% confidence intervals (95%CI).RESULTS: Children with bacterial meningitis had increased risks of PNDD, especially learning and intellectual developmental disorders (young infants: aHR 4.2, 95%CI: 2.4-7.1; older children: aHR 1.5, 95%CI: 1.0-2.3), attention deficit disorder (ADHD) (young infants: aHR 2.8, 95%CI: 1.5-5.2; older children: 1.4, 95%CI: 0.9-2.2) and redemption of ADHD medication (young infants: aHR 2.2, 95%CI: 1.0-4.7; older children: 1.5, 95%CI: 1.0-2.3). Young infants with bacterial meningitis additionally had increased risks of autism spectrum disorders (aHR 1.9, 95%CI: 0.9-4.1) and behavioural and emotional disorders (aHR 2.0, 95%CI: 1.0-3.9). In young infants, the excess risk of PNDD was especially observed in premature children. Siblings of older children with bacterial meningitis also had increased risks of PNDD. Children with enteroviral meningitis at any age did not have increased risks of PNDD or redemption of ADHD medication.CONCLUSIONS: Bacterial meningitis in childhood is associated with subsequent diagnosis of PNDD, while enteroviral meningitis is not. The association appears to be partly explained by prematurity and familial and socioeconomic factors.
KW - Adolescent
KW - Attention Deficit Disorder with Hyperactivity/epidemiology
KW - Child
KW - Child, Preschool
KW - Cohort Studies
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Meningitis, Bacterial/epidemiology
KW - Meningitis, Viral/epidemiology
KW - Neurodevelopmental Disorders/epidemiology
KW - Proportional Hazards Models
KW - Risk Factors
KW - Siblings
U2 - 10.1080/23744235.2024.2399101
DO - 10.1080/23744235.2024.2399101
M3 - Article
C2 - 39230517
SN - 2374-4235
VL - 57
SP - 89
EP - 99
JO - Infectious Diseases
JF - Infectious Diseases
IS - 1
ER -