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Open Access 01-12-2023 | Research

Cerebral oxygenation immediately after birth and long-term outcome in preterm neonates—a retrospective analysis

Authors: Christina H. Wolfsberger, Elisabeth Pichler-Stachl, Nina Höller, Lukas P. Mileder, Bernhard Schwaberger, Alexander Avian, Berndt Urlesberger, Gerhard Pichler

Published in: BMC Pediatrics | Issue 1/2023

Abstract

Background

Prematurity is associated with increased risk for morbidity and mortality. Aim of this study was to evaluate whether cerebral oxygenation during fetal-to-neonatal transition period was associated with long-term outcome in very preterm neonates.

Methods

Preterm neonates ≤ 32 weeks of gestation and/or ≤ 1500 g with measurements of cerebral regional oxygen saturation (crSO₂) and cerebral fractional tissue oxygen extraction (cFTOE) within the first 15 min after birth were analysed retrospectively. Arterial oxygen saturation (SpO₂) and heart rate (HR) were measured with pulse oximetry. Long-term outcome was assessed at two years using “Bayley Scales of Infant Development” (BSID-II/III). Included preterm neonates were stratified into two groups: adverse outcome group (BSID-III ≤ 70 or testing not possible due to severe cognitive impairment or mortality) or favorable outcome group (BSID-III > 70). As the association between gestational age and long-term outcome is well known, correction for gestational age might disguise the potential association between crSO₂ and neurodevelopmental impairment. Therefore, due to an explorative approach the two groups were compared without correction for gestational age.

Results

Forty-two preterm neonates were included: adverse outcome group n = 13; favorable outcome group n = 29. Median(IQR) gestational age and birth weight were 24.8 weeks (24.2–29.8) and 760 g (670–1054) in adverse outcome group and 30.6 weeks (28.1–32.0) (p = 0.009*) and 1250 g (972–1390) (p = 0.001*) in the favorable outcome group, respectively. crSO₂ was lower (significant in 10 out of 14 min) and cFTOE higher in adverse outcome group. There were no difference in SpO₂, HR and fraction of inspired oxygen (FiO₂), except for FiO₂ in minute 11, with higher FiO₂ in the adverse outcome group.

Conclusion

Preterm neonates with adverse outcome had beside lower gestational age also a lower crSO₂ during immediate fetal-to-neonatal transition when compared to preterm neonates with age appropriate outcome. Lower gestational age in the adverse outcome group would suggest beside lower crSO₂ also lower SpO₂ and HR in this group, which were however similar in both groups.

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Title: Cerebral oxygenation immediately after birth and long-term outcome in preterm neonates—a retrospective analysis
Authors: Christina H. Wolfsberger
Elisabeth Pichler-Stachl
Nina Höller
Lukas P. Mileder
Bernhard Schwaberger
Alexander Avian
Berndt Urlesberger
Gerhard Pichler
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2023
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-023-03960-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cerebral oxygenation immediately after birth and long-term outcome in preterm neonates—a retrospective analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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