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Cerebral oxygenation is associated with neurodevelopmental outcome of preterm children at age 2 to 3 years.
Verhagen, Elise A 1; Van Braeckel, Koenraad N J A 1; van der Veere, Christa N 1; Groen, Henk 2; Dijk, Peter H 1; Hulzebos, Christian V 1; Bos, Arend F 1
[Article] Developmental Medicine & Child Neurology. 57(5):449-455, May 2015.

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AIM: The aim of the study was to determine whether regional cerebral tissue oxygen saturation (rcSO2) and fractional tissue oxygen extraction (FTOE), using near-infrared spectroscopy, are associated with neurodevelopmental outcome of preterm infants.

METHOD: We measured rcSO2 on days 1, 2, 3, 4, 5, 8, and 15 after birth in 83 preterm infants (<32wks gestational age), and calculated FTOE=(SpO2-rcSO2)/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 rcSO2 and FTOE contributed to outcome.

RESULTS: We followed up 67 infants. The lower quartile (P25-50) and highest quartile (P75-100) of rcSO2 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 rcSO2 was associated with poorer cognitive outcome (p=0.014). The lower quartile (P25-50) AUC of rcSO2 was associated with poorer fine motor outcome (p=0.004). The amount of time rcSO2 <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).

INTERPRETATION: 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 rcSO2 on day 1 were associated with poorer neurodevelopmental outcome.