Cerebral oxygenation is associated with neurodevelopmental outcome of preterm children at age 2 to 3 years.
OBJECTIVE
The aim of the study was to determine whether regional cerebral tissue oxygen saturation (r(c)SO2) and fractional tissue oxygen extraction (FTOE), using near-infrared spectroscopy, are associated with neurodevelopmental outcome of preterm infants.


METHODS
We measured rc SO2 on days 1, 2, 3, 4, 5, 8, and 15 after birth in 83 preterm infants (<32wks gestational age), and calculated FTOE=(SpO2 -r(c)SO2)/SpO2. Cognitive, motor, neurological, and behavioural outcomes were determined at 2 to 3 years using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), an age-specific neurological examination, and the Child Behavior Checklist (CBCL) respectively. Multiple linear regression analyses were used to determine whether r(c)SO2 and FTOE contributed to outcome.


RESULTS
We followed up 67 infants. The lower quartile (P(25-50)) and highest quartile (P(75-100)) of r(c)SO2 on day 1 were associated with poorer cognitive outcome (p=0.044 and p=0.008 respectively). A lower area under the curve (AUC; over 15d) of r(c)SO2 was associated with poorer cognitive outcome (p=0.014). The lower quartile (P(25-50)) AUC of r(c)SO2 was associated with poorer fine motor outcome (p=0.004). The amount of time r(c)SO2 <50% on day 1 was negatively associated with gross motor outcome (p=0.002). The highest quartile of FTOE on day 1 was associated with poorer total motor outcome (p=0.041).


CONCLUSIONS
Cerebral oxygen saturation during the first 2 weeks after birth is associated with neurodevelopmental outcome of preterm infants at 2 to 3 years. High and low r(c)SO2 on day 1 were associated with poorer neurodevelopmental outcome.
Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Elise A
EA
Verhagen
Koenraad N J A
KN
Van Braeckel
Christa N
CN
van der Veere
Henk
H
Groen
Peter H
PH
Dijk
Christian V
CV
Hulzebos
Arend F
AF
Bos
D001921:Brain / Q000378:metabolism*; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption / Q000502:physiology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
D010100:Oxygen