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 (<32wks gestational age), and calculated FTOE =(SpO 2 –r c SO 2 )/SpO 2 . 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 SO 2 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 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 (P 25–50 ) 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 2 weeks after birth is associated with neurodevelopmental outcome of preterm infants at 2 to 3 years. High and low r c SO 2 on day 1 were associated with poorer neurodevelopmental outcome.