Foetal growth, birth transition, enteral nutrition and brain light scattering

Osuke Iwata,Sachio Takashima,Mamoru Saikusa,Yuko Araki,Shiji Saitoh,Etsuko Ohmae,Sachiko Iwata,Motoki Oda,Yung-Chieh Lin,Masahiro Kinoshita,Tsuyoshi Kurata,Koya Kawase,Kennosuke Tsuda

doi:10.1038/s41598-021-00624-9

Abstract

If the brain structure is assessed at neonatal intensive care units, covert clinical events related with subtle brain injury might be identified. The reduced scattering coefficient of near-infrared light (μS’) obtained using time-resolved near-infrared spectroscopy from the forehead of infants is associated with gestational age, body weight and Apgar scores, presumably reflecting subtle changes of the brain related to foetal growth and birth transition. One hundred twenty-eight preterm and term infants were studied to test whether μS’ obtained from the head at term-equivalent age is associated with foetal growth, birth transition and nutritional status after birth, which are key independent variables of developmental outcomes. As potential independent variables of μS’, birth weight, Apgar scores, age at full enteral feeding and post-conceptional age at the study were assessed to represent foetal growth, birth transition and nutritional status after birth. Subsequently, higher μS’ values were associated with higher Apgar scores (p = 0.003) and earlier establishment of enteral feeding (p < 0.001). The scattering property of near-infrared light within the neonatal brain might reflect changes associated with birth transition and nutritional status thereafter, which might be used as a non-invasive biomarker to identify covert independent variables of brain injury in preterm infants.

Highlights

If the brain structure is assessed at neonatal intensive care units, covert clinical events related with subtle brain injury might be identified
Magnetic resonance imaging (MRI) studies in preterm infants have demonstrated the relationship between subtle brain lesions at term equivalent age and long-term cognitive impairments[5,6,7]
Because of the cost, time and safety associated with the scan, MRI is usually performed only once before discharge from the hospital, causing difficulty in identification of the upstream events associated with subtle brain lesions

Summary

Introduction

If the brain structure is assessed at neonatal intensive care units, covert clinical events related with subtle brain injury might be identified. The reduced scattering coefficient of near-infrared light (μS’) obtained using time-resolved near-infrared spectroscopy from the forehead of infants is associated with gestational age, body weight and Apgar scores, presumably reflecting subtle changes of the brain related to foetal growth and birth transition. The scattering property of near-infrared light within the neonatal brain might reflect changes associated with birth transition and nutritional status thereafter, which might be used as a noninvasive biomarker to identify covert independent variables of brain injury in preterm infants. Our study in preterm and term infants further confirmed that μS’ values obtained shortly after birth were associated with variables, such as antenatal glucocorticoid, emergency delivery, gestational age, body size, Apgar scores, requirement for mechanical ventilation and blood gas data at birth, suggesting the possibility that μS’ might reflect subtle structural changes in the brain associated with antenatal growth, peripartum stress and birth transition[17]. The aim of this study was to test the association of μS’ measured at term-equivalent period with intrauterine growth, birth transition and nutrition after birth, which are short-term surrogate markers for neurodevelopmental outcomes of hospitalised newborn infants[18,19,20,21]

Objectives

Methods

Results

Discussion

Conclusion