• Thomas Alderliesten, Frank van Bel, Niek E van der Aa, Paul Steendijk, Ingrid C van Haastert, Linda S de Vries, Floris Groenendaal, and Petra Lemmers.
• Department of Neonatology, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands. Electronic address: t.alderliesten-2@umcutrecht.nl.
• J. Pediatr. 2019 Apr 1; 207: 109-116.e2.

ObjectiveTo assess whether high and low levels of cerebral oxygenation (regional cerebral oxygenation [rScO2]) in infants born at <32 weeks of gestation were associated with adverse long-term outcome.Study DesignObservational cohort study including preterm infants born at <32 weeks of gestation at the Wilhelmina Children's Hospital, The Netherlands, between April 2006 and April 2013. The rScO2 was continuously monitored for 72 hours after birth using near-infrared spectroscopy. Outcome was assessed at 15 and 24 months of corrected age by certified investigators. An unfavorable composite outcome was defined as an outcome score below -1 SD or death. Various rScO2 thresholds were explored.ResultsIn total, 734 infants were eligible for analysis, 60 of whom died. Associations with an unfavorable cognitive outcome in multivariable analysis were comparable for time spent with a rScO2 below 55% and -1.5 SD (according to published reference values), with an OR of 1.4 (CI 1.1-1.7) for 20% of time below either threshold. Results at 15 months were comparable with results at 24 months. Results were not statistically significant for thresholds defining high values of rScO2. The composite motor outcome was not significantly related to either low or high values or rScO2.ConclusionsLow, but not high, rScO2 was associated with an unfavorable cognitive outcome. This suggests the use of a threshold of rScO2 <55% for future clinical studies when using adult near-infrared sensors (rScO2 <65% for neonatal sensors, approximately).Copyright © 2018 Elsevier Inc. All rights reserved.

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