Related Experiment Video
Updated: Dec 12, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm
Christina Helene Wolfsberger1,2, Marlies Bruckner1,2, Nariae Baik-Schneditz1,2
1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Insights
Fetal inflammatory response syndrome (FIRS) in preterm infants was linked to lower fractional tissue oxygen extraction (cFTOE) but similar cerebral oxygen saturation (crSO2) post-birth. This suggests altered oxygen delivery and consumption in FIRS neonates.
Area of Science:
- Neonatal Medicine
- Perinatal Physiology
- Pediatric Critical Care
Background:
- Fetal inflammatory response syndrome (FIRS), indicated by elevated cord blood IL-6, increases neonatal morbidity and mortality risks.
- Understanding FIRS's impact on immediate postnatal cerebral oxygenation is crucial for preterm infant outcomes.
Purpose of the Study:
- To assess FIRS influence on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition.
- To investigate FIRS's association with cerebral injury and mortality in preterm neonates.
Main Methods:
- Analysis of secondary outcomes from prospective observational studies.
- Inclusion of preterm neonates with measured IL-6 and cerebral NIRS data.
- 1:1 matching of FIRS and non-FIRS preterm neonates by gestational age.
Main Results:
- Lower cFTOE values observed in the FIRS group within the first 4 minutes post-birth.
- No significant differences in crSO2 between FIRS and non-FIRS groups in the first 15 minutes.
- Lower SpO2 and heart rate noted in the FIRS group during early postnatal minutes.
Conclusions:
- Preterm neonates with FIRS exhibit similar crSO2 despite lower cFTOE, suggesting compromised cerebral oxygen delivery/consumption.
- Findings highlight potential physiological alterations in FIRS neonates during the critical postnatal transition period.
Abstract:
Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality. Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups. Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3-33.0) weeks; median IL-6 19.7 (IQR 12.2-37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4-33.1) weeks; IL-6: 5.4 (3.0-6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups. Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS.
More Related Videos
07:27How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
05:52Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
