Related Experiment Video
Updated: Apr 26, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Cerebral Oxygenation during the First 15 Minutes after Birth and Short-Term Outcome Measured by the Motor Optimality
Anna Scheuchenegger1,2, Christina H Wolfsberger3,4, Alexander Avian5
1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria, a.scheuchenegger@medunigraz.at.
Insights
Near-infrared spectroscopy (NIRS) monitoring during infant resuscitation improved early motor outcomes. This targeted cerebral oxygenation approach showed better motor performance in preterm infants, suggesting a positive impact on neurodevelopment.
Area of Science:
- Neonatal care
- Neurodevelopmental pediatrics
- Medical technology assessment
Background:
- Cerebral hypoxia detection during immediate postnatal transition is crucial for mitigating adverse outcomes.
- Near-infrared spectroscopy (NIRS) allows monitoring of cerebral regional oxygen saturation (crSO₂).
- General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), evaluates early motor development.
Purpose of the Study:
- To assess differences in early motor outcomes at 6-20 weeks corrected age based on NIRS-guided resuscitation in preterm infants.
- To evaluate the impact of continuous crSO₂ monitoring on motor development in the COSGOD III trial.
Main Methods:
- Retrospective ancillary observational study of preterm infants (<32 weeks' gestation) from the COSGOD III trial.
- Infants were allocated to either NIRS-guided resuscitation or a control group.
- Motor outcome was assessed using the Motor Optimality Score-Revised (MOS-R) derived from General Movement Assessment (GMA) video recordings.
Main Results:
- A total of 162 preterm infants were included (NIRS: n=76; control: n=86).
- No significant difference in the presence of normal fidgety movements (FMs) was observed between groups (96% vs. 94%).
- Infants in the NIRS group demonstrated significantly higher MOS-R scores (median [IQR]: 26 [24-28] vs. 24 [22-26]; p=0.003), indicating better motor performance, with 83% showing age-adequate repertoire compared to 66% in the control group (p=0.003).
Conclusions:
- NIRS-guided management during immediate postnatal transition was associated with improved early motor performance in preterm infants.
- While fidgety movement presence was similar, enhanced motor outcomes suggest targeted cerebral oxygenation influences early neurodevelopment.
- This highlights the potential of NIRS monitoring to optimize resuscitation strategies and improve long-term neurodevelopmental outcomes.
Introduction:
Monitoring cerebral regional oxygen saturation (crSO₂) using near-infrared spectroscopy (NIRS) during immediate postnatal transition may help detect and mitigate cerebral hypoxia. General movement assessment (GMA), including fidgety movements (FMs) and the Motor Optimality Score-Revised (MOS-R), is widely used to evaluate early motor development.
Methods:
The objective was to assess differences in early motor outcome at 6-20 weeks corrected age according to group allocation in the randomized multicenter COSGOD III trial. This was a retrospective ancillary observational study. Preterm infants (<32 weeks' gestation) enrolled in COSGOD III at two Austrian centers (Graz and Inns-bruck) with available GMA video recordings at 6-20 weeks corrected age were included. MOS-R was scored retrospectively from these recordings. In COSGOD III, infants randomized to the NIRS group received continuous crSO₂ monitoring during immediate postnatal transition to guide resuscitation; in the control group, crSO₂ values were not displayed. The main outcome measure was MOS-R (range 5-28) derived from GMA video analysis.
Results:
A total of 162 infants were included (NIRS: n = 76; control: n=86; median gestational age 29.6 vs. 28.8 weeks; p = 0.357). Normal FMs were present in 95% of infants (96% vs. 94%). However, MOS-R scores were significantly higher in the NIRS group (median [IQR]: 26 [24-28] vs. 24 [22-26]; p = 0.003), with more infants showing an age-adequate motor repertoire (83% vs. 66%; p = 0.003).
Conclusion:
Although FM presence was similar between groups, NIRS-guided management during immediate transition was associated with improved early motor performance, suggesting that targeted cerebral oxygenation may influence early neurodevelopment.
