Neonatal cerebral oxygenation is not linked to foetal vasculitis and predicts intraventricular haemorrhage in preterm infants.
OBJECTIVE
The aim of the study was to compare the cerebral tissue oxygenation index (c-TOI) measured by near infrared spectroscopy (NIRS) in infants with and without foetal vasculitis.


METHODS
Twenty-four infants with placental signs of a foetal inflammatory response (FIR), foetal vasculitis, were compared with 39 controls. NIRS examination was done within the first 24 h.


RESULTS
Infants with FIR had a significant lower gestational age (26.8 +/- 2.4 vs. 29.8 +/- 2.4 weeks' gestation; p < 0.01), Hb (9.4 +/- 1.2 vs. 10.9 +/- 1.5 mM; p < 0.01) and blood P(CO2) (5.5 +/- 0.8 vs. 6.3 +/- 1.1 kPa, p < 0.01) compared to controls. There was no significant difference in arterial blood pressure, inspiratory oxygen content, needs of mechanical ventilation or c-TOI (73.6 +/- 8.1% vs. 73.9 +/- 8.1% (p = 0.9)). The effect of FIR on c-TOI was -0.3% (95% CI -3.9 to 4.5%). This result was not affected by inclusion of potential confounders in the analysis. Eight infants subsequently developed intra/periventricular haemorrhage: four with minor lesions and four with severe lesions. There was a significant negative correlation between the severity of the intraventricular haemorrhage and the cerebral oxygenation (p = 0.002).


CONCLUSIONS
Cerebral oxygenation was not affected in the first day of life in preterm infants born with foetal vasculitis, while cerebral oxygenation in infants that later developed intraventricular haemorrhage was impaired.
Sorensen
Line C
LC
Department of Paediatrics and Neonatology, Copenhagen University Hospital, Hvidovre, Denmark. lcs@dadlnet.dk
Maroun
Lisa L
LL
Borch
Klaus
K
Lou
Hans C
HC
Greisen
Gorm
G
D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D054022:Cerebrum / Q000502:physiology*; D005260:Female; D005315:Fetal Diseases / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D020300:Intracranial Hemorrhages / Q000503:physiopathology; D008297:Male; D010100:Oxygen / Q000502:physiology*; D010920:Placenta / Q000473:pathology; D014657:Vasculitis / Q000473:pathology / Q000503:physiopathology*
D010100:Oxygen