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Updated: Jul 2, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Preterm infants experience a nadir in cerebral oxygenation during sleep three months after hospital discharge
Alicia K Yee1, Marisha Shetty1, Leon S Siriwardhana1
1Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Insights
Preterm infants experiencing central apnoeas show reduced cerebral oxygenation at 3 months, coinciding with peak Sudden Infant Death Syndrome (SIDS) risk. This finding highlights a potential link between breathing issues and SIDS in vulnerable infants.
Area of Science:
- Neonatal physiology
- Respiratory control in infants
- Neurodevelopmental studies
Background:
- Preterm infants face higher risks of Sudden Infant Death Syndrome (SIDS).
- Central apnoeas, or pauses in breathing, are common in preterm infants.
- These apnoeas can occur during sleep and may impact brain oxygen levels.
Purpose of the Study:
- To examine the relationship between central apnoeas and cerebral oxygenation in preterm infants.
- To assess changes in cerebral oxygenation from hospital discharge up to 6 months corrected age.
- To determine if apnoea patterns correlate with brain oxygenation levels over time.
Main Methods:
- Studied preterm infants (28-32 weeks gestational age) at multiple time points: 32-36, 36-40 weeks post-menstrual age, and 3 & 6 months corrected age.
- Continuously recorded cerebral tissue oxygenation (TOI), peripheral oxygenation (SpO2), and heart rate during sleep.
- Calculated percentage total sleep time (%TST) with central apnoeas and cerebral fractional oxygen extraction.
Main Results:
- Central apnoeas decreased with age in both active and quiet sleep.
- Cerebral tissue oxygenation (TOI) was lowest at 3 months corrected age.
- Cerebral fractional oxygen extraction was highest at 3 months corrected age, particularly during quiet sleep.
Conclusions:
- Reduced cerebral oxygenation at 3 months in preterm infants aligns with the highest risk period for SIDS.
- This dip in brain oxygenation may be a contributing factor to the increased SIDS risk observed in these infants.
- Further research is warranted to explore interventions to improve cerebral oxygenation and mitigate SIDS risk.
Aim:
Preterm infants are at increased risk of Sudden Infant Death Syndrome (SIDS) and frequently experience short central apnoeas which can occur in isolation or a repetitive pattern (periodic breathing). We investigated the relationship between central apnoeas experienced before and over the 6 months after hospital discharge and cerebral oxygenation.
Methods:
Preterm infants born between 28 and 32 weeks gestational age (GA) were studied during supine daytime sleep at 32-36 weeks post menstrual age (PMA) (n = 40), 36-40 weeks PMA (n = 27), 3-months corrected age (CA) (n = 20) and 6-months CA (n = 26). Cerebral tissue oxygenation (TOI), peripheral oxygenation (SpO2) and heart rate were recorded continuously. The percentage total sleep time (%TST) spent having central apnoeas at each study and cerebral fractional oxygen extraction (SpO2-TOI/SpO2) were calculated.
Results:
%TST spent with central apnoeas decreased with increasing age in both active sleep (AS) and quiet sleep (QS). TOI tended to be lower and cerebral fractional oxygen extraction higher at 3 months compared to the other studies and this reached statistical significance compared to 32-36 weeks in QS.
Conclusion:
The nadir in cerebral tissue oxygenation at 3 months of age coincides with the peak risk period for SIDS and this may contribute to increased risk in these infants.
