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Updated: Jul 28, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal Cerebrovascular Stability Index and Oxygenation With 3-Month Neurodevelopmental Outcomes
Ashley Ibrahim1, Jodie K Votava-Smith2, John C Wood2
1Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California, USA; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Background:
Limited studies examined associations between proxies of cerebrovascular autoregulation and neurodevelopmental outcomes (NDOs) in congenital heart disease (CHD).
Objectives:
Our objectives were to determine: 1) associations of neonatal cerebrovascular stability index (CSI) and mean regional cerebral oxygenation (rcSO2) with 3-month NDOs within CHD and control groups and within CHD subgroups; and 2) group and subgroup differences in these associations.
Methods:
This study was a secondary analysis of a longitudinal cohort study in CHD and control infants. We calculated neonatal CSI as: 2-minute mean sitting rcSO2-2-minute mean supine rcSO2. The Bayley-III measured 3-month NDOs. Linear regressions examined associations of CSI and rcSO2 with NDOs, and interaction terms examined group and subgroup differences in associations.
Results:
Our sample included 70 infants (41 control and 29 CHD). CSI and rcSO2 associated with cognitive scores (P = 0.03 and P = 0.02, respectively) in CHD infants. CHD and healthy controls groups differed in associations; CSI positively associated with motor scores (P = 0.02) in CHD, although did not associate in controls, and rcSO2 positively associated with cognitive scores (P = 0.01) in CHD, although negatively associated in controls. rcSO2 associated with language scores (P = 0.01) in the biventricular subgroup. CSI associated with motor scores (P = 0.04) and rcSO2 associated with cognitive scores (P = 0.01) in the cyanotic subgroup.
Conclusions:
Neonatal CSI and rcSO2 associated with 3-month cognitive and motor outcomes in CHD and CHD subgroups, and groups differed in their directional associations. Future studies should explore CSI as an indicator of risk for developmental delays in CHD.
