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

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Preterm neonates ≤ 32 weeks of gestation and/or ≤ 1500 g with measurements of cerebral regional oxygen saturation (crSO<jats:sub>2</jats:sub>) and cerebral fractional tissue oxygen extraction (cFTOE) within the first 15 min after birth were analysed retrospectively. Arterial oxygen saturation (SpO<jats:sub>2</jats:sub>) 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 &gt; 70). As the association between gestational age and long-term outcome is well known, correction for gestational age might disguise the potential association between crSO<jats:sub>2</jats:sub> and neurodevelopmental impairment. Therefore, due to an explorative approach the two groups were compared without correction for gestational age.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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) <jats:italic>(p = 0.009*)</jats:italic> and 1250 g (972–1390) <jats:italic>(p = 0.001*)</jats:italic> in the favorable outcome group, respectively. crSO<jats:sub>2</jats:sub> was lower (significant in 10 out of 14 min) and cFTOE higher in adverse outcome group. There were no difference in SpO<jats:sub>2</jats:sub>, HR and fraction of inspired oxygen (FiO<jats:sub>2</jats:sub>), except for FiO<jats:sub>2</jats:sub> in minute 11, with higher FiO<jats:sub>2</jats:sub> in the adverse outcome group.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Preterm neonates with adverse outcome had beside lower gestational age also a lower crSO<jats:sub>2</jats:sub> 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 crSO<jats:sub>2</jats:sub> also lower SpO<jats:sub>2</jats:sub> and HR in this group, which were however similar in both groups.</jats:p></jats:sec>

Topics

• impedance spectroscopy
• Oxygen
• extraction
• size-exclusion chromatography