Cerebral oxygenation is associated with neurodevelopmental outcome of preterm children at age 2 to 3 years

Aim The aim of the study was to determine whether regional cerebral tissue oxygen saturation (r(c)SO(2)) and fractional tissue oxygen extraction (FTOE), using near-infrared spectroscopy, are associated with neurodevelopmental outcome of preterm infants. Method We measured r(c)SO(2) on days 1, 2, 3, 4, 5, 8, and 15 after birth in 83 preterm infants (<32 wks gestational age), and calculated FTOE=(SpO(2)-r(c)SO(2))/SpO(2). Cognitive, motor, neurological, and behavioural outcomes were determined at 2 to 3years 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)SO(2) and FTOE contributed to outcome. Results We followed up 67 infants. The lower quartile (P25-50) and highest quartile (P75-100) of r(c)SO(2) 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)SO(2) was associated with poorer cognitive outcome (p=0.014). The lower quartile (P25-50) AUC of r(c)SO(2) was associated with poorer fine motor outcome (p=0.004). The amount of time r(c)SO(2) <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 2weeks after birth is associated with neurodevelopmental outcome of preterm infants at 2 to 3years. High and low r(c)SO(2) on day 1 were associated with poorer neurodevelopmental outcome.