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Updated: Jan 31, 2026

Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
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Low Cerebral Oxygenation in Preterm Infants Is Associated with Adverse Neurodevelopmental Outcome

Thomas Alderliesten1, Frank van Bel1, Niek E van der Aa1

  • 1Department of Neonatology, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.

The Journal of Pediatrics
|December 23, 2018
PubMed

Insights

Low cerebral oxygenation in preterm infants is linked to poorer cognitive outcomes. This study suggests monitoring regional cerebral oxygenation (rScO2) levels is crucial for assessing long-term neurodevelopmental risks in vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Neuroscience
  • Pediatric Neurology

Background:

  • Preterm infants (<32 weeks gestation) face risks for adverse neurodevelopmental outcomes.
  • Cerebral oxygenation, measured as regional cerebral oxygenation (rScO2), is a critical physiological parameter in neonates.
  • Understanding the relationship between rScO2 levels and long-term outcomes is essential for improving infant care.

Purpose of the Study:

  • To investigate the association between high and low levels of regional cerebral oxygenation (rScO2) and adverse long-term outcomes in preterm infants.
  • To determine specific rScO2 thresholds indicative of potential neurodevelopmental impairment.

Main Methods:

  • An observational cohort study of 734 preterm infants (<32 weeks gestation) monitored for rScO2 using near-infrared spectroscopy for 72 hours post-birth.
  • Long-term outcomes (cognitive and motor) were assessed at 15 and 24 months corrected age.
  • Multivariable analysis explored associations between various rScO2 thresholds and unfavorable composite outcomes (defined as score <-1 SD or death).

Main Results:

  • Low rScO2, specifically time spent below 55% (using adult sensors), was significantly associated with unfavorable cognitive outcomes (OR 1.4; CI 1.1-1.7).
  • Associations remained consistent at 15 and 24 months corrected age.
  • High rScO2 levels and composite motor outcomes showed no significant relationship with rScO2 variations.

Conclusions:

  • Low regional cerebral oxygenation, not high levels, is linked to adverse cognitive development in preterm infants.
  • A threshold of rScO2 <55% (adult sensors) is proposed for future clinical studies monitoring neurodevelopmental risk.
Abstract

Keywords:
Near-infrared spectroscopyhemodynamicsneonatologyneurology

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