title: Comparison of changes in cerebral and systemic perfusion between appropriate- and small-for-gestational-age infants during the first three days after birth.
abstract: OBJECTIVE
  The aims of the current study were to compare changes in cerebral and systemic perfusion in appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants immediately after birth.
  
  
  METHODS
  Cerebral blood volume (CBV), cerebral Hb oxygen saturation (cSO2) and cerebral fractional tissue oxygen extraction (cFTOE) among 57 AGA infants and 30 SGA infants were monitored using a newly developed time-resolved spectroscopy system during the first 3days of life. The left ventricular ejection fraction (LVEF), left ventricular cardiac output (LVCO) and E/e' values were determined by three-dimensional echocardiography and tissue Doppler imaging performed simultaneously.
  
  
  RESULTS
  There were significant differences between the body weights of both the AGA and SGA infants, but not between the gestational age and head circumferences in both groups. Although CBV showed no significant difference between the groups, cSO2 was significantly higher and cFTOE was lower in SGA infants than in AGA infants. Hematocrit (Ht) levels were significantly higher and LVEF and LVCO were lower in SGA infants than in AGA infants. Negative correlation was observed between CBV and Ht levels in AGA infants, but not in SGA infants.
  
  
  CONCLUSIONS
  The high Ht levels and vasoreactivity in SGA infants might be a compensatory mechanism in order to maintain oxygen delivery to the brain, which reflects the condition of chronic hypoxia during the fetal period and also reflects the weak contraction and low cardiac output of the left ventricle sustaining the relatively large brain from the fetal period to after birth.
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan. Electronic address: h-ishii@tokyo-med.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takami
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Tao
authors.initials: T
authors.lastname: Fujioka
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Mizukaki
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kondo
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sunohara
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Hoshika
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Medical University, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Akutagawa
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Medical University, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Isaka
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D001921:Brain / Q000254:growth & development* / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D019560:Echocardiography, Three-Dimensional; D006257:Head / Q000033:anatomy & histology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D009929:Organ Size; D010100:Oxygen / Q000378:metabolism; D012044:Regression Analysis; D013057:Spectrum Analysis; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D010100:Oxygen
keywords: Cerebral Hb oxygen saturation (cSO(2)); Cerebral blood volume (CBV); Intrauterine growth restriction (IUGR); Near-infrared spectroscopy (NIRS); Small-for-gestational-age (SGA); Three-dimensional (3D) echocardiography; Time-resolved spectroscopy (TRS)