Follow-up study of survivors of fetal and early onset neonatal listeriosis

Although fetal or neonatal infection with Listeria monocytogenes is known to have a high mortality, the longterm morbidity is unknown. Clinical sequelae of fetal or neonatal listeriosis were studied in eight survivors of such infections at a mean age of 16 months corrected for prematurity. A developmental and health history was taken and a Denver Developmental Screening Test and neurological exam performed on each subject. Two infants were seen again and the remainder had developmental and health histories obtained from their mothers and primary physicians at a mean age of 31 months. Six of the eight infants studied had no evidence of neurodevelopmental sequelae. Four of these six had mild or no clinical disease after birth. However, two of the six intact survivors, both born prematurely, were critically ill in the early postnatal period. The two remaining infants had neurodevelopmental handicap. In addition to being prematurely born with severe perinatal disease, these two had CNS complications in the newborn period, both with meningitis and one with intraventricular hemorrhage. Although intelligence in both appeared to be normal, one had mild and the other moderate spastic diplegia. Severe perinatal disease, including fetal or neonatal death, appeared to be related to delayed or no antepartum antibiotic therapy of mothers. Premature delivery appeared to be an important factor both in the severity of disease and in the development of longterm handicap. There were no deaths and no longterm sequelae in infants born at a gestational age greater than 37 weeks. However, in the absence of meningitis and other CNS complications, it would appear that the prognosis even for prematurely born survivors of perinatal listeriosis is very good.