Can Use of Cerebral Oxygenation Predict Developmental Outcomes in Preterm Infants With NEC?

Abstract

* Abbreviations: NEC — : necrotizing enterocolitis NIRS — : near-infrared spectroscopy In this issue of Pediatrics, Howarth et al1 report on a completed longitudinal study of 46 preterm infants born at <30 weeks’ gestational age in which they recorded cerebral oxygenation using near-infrared spectroscopy (NIRS) for 1 hour per week until hospital discharge or transfer. The 6 infants who developed necrotizing enterocolitis (NEC) had consistently lower levels of cerebral oxygenation (mean −6.6%) and small increases in cerebral fractional tissue oxygen extraction (mean 0.08) throughout the study. Using multilevel mixed-effects linear models nested within each infant, the authors adjusted for a large number of confounding variables, including patent ductus arteriosus, sex, ethnicity, volume of enteral feeding, hemoglobin, and gestational age. Although the small number of infants who developed NEC limited the study, the study provides preliminary evidence that lowered cerebral oxygenation may underpin the worse neurodevelopmental outcomes that have been reported in preterm infants with NEC.2–4 Worldwide, >15 million infants are born preterm (<37 weeks’ gestation) each year, and these rates are increasing. Improvements in the care of these infants have dramatically improved survival. However, contrary to expectations, recent data, in which outcomes in … Address correspondence to Rosemary S.C. Horne, PhD, DSc, Department of Paediatrics, Level 5, Monash Children’s Hospital, 246 Clayton Rd, Melbourne, VIC 3168, Australia. E-mail: rosemary.horne{at}monash.edu