2NICU and Neonatology Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Thessaloniki 56403, Greece, Tel.: +966534548081.
2NICU and Neonatology Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Perinat Med. 2020 Mar 26;48(3):280-288. doi: 10.1515/jpm-2019-0274.
Objective To examine cerebral oxygenation and perfusion in small for gestational age (SGA) compared with appropriate for gestational age (AGA) neonates during the first postnatal week, and to investigate any association with neurodevelopmental outcomes at 24-36 months of age. Methods A prospective matched case-control study was conducted evaluating cerebral oxygenation and perfusion, using near-infrared spectroscopy (NIRS), between SGA and AGA neonates, during the first postnatal week. A neurodevelopmental assessment with Bayley-III was performed at 24-36 months of age. Results Forty-eight SGA and 48 AGA neonates of similar gestation (32.8 ± 2.1 vs. 32.5 ± 1.9) were enrolled. On the first postnatal day, the cerebral oxygenation was equal between SGA and AGA neonates (71 ± 7% vs. 72 ± 8%); however, in the subgroup analysis, males had higher oxygenation compared to female SGA neonates (73 ± 7% vs. 69 ± 7%, P = 0.04). Cerebral perfusion was significantly higher in SGA neonates on the first postnatal day (1.4 ± 0.6 vs. 1.1 ± 0.5, P = 0.04), but this difference was diminished on subsequent measurements. There were no significant differences between the SGA and AGA infants regarding the composite cognitive, communication and motor index scores. The length of mechanical ventilation and late-onset sepsis were significant risk factors affecting the cognitive and communication composite index scores, respectively. Conclusion Cerebral oxygenation was equal between SGA and AGA neonates, while cerebral perfusion was transiently increased in SGA neonates during the first postnatal day. There was no significant association of cerebral oxygenation and perfusion with neurodevelopmental outcomes.
研究小于胎龄儿（SGA）与适于胎龄儿（AGA）新生儿在出生后第一周的脑氧合和灌注情况，并探讨其与 24-36 个月神经发育结局的关系。
这是一项前瞻性匹配病例对照研究，通过近红外光谱（NIRS）评估 SGA 和 AGA 新生儿在出生后第一周的脑氧合和灌注情况。在 24-36 个月时进行贝利 III 神经发育评估。
共纳入 48 例 SGA 和 48 例 AGA 新生儿，胎龄相似（32.8±2.1 与 32.5±1.9）。在出生后第一天，SGA 和 AGA 新生儿的脑氧合情况相似（71±7%与 72±8%）；然而，在亚组分析中，男性 SGA 新生儿的氧合情况高于女性（73±7%与 69±7%，P=0.04）。SGA 新生儿在出生后第一天的脑灌注明显较高（1.4±0.6 与 1.1±0.5，P=0.04），但随后的测量值差异缩小。SGA 和 AGA 婴儿在认知、沟通和运动综合指数得分方面没有显著差异。机械通气时间和晚发性败血症的长度是影响认知和沟通综合指数得分的显著危险因素。
SGA 和 AGA 新生儿的脑氧合情况相当，而 SGA 新生儿在出生后第一天脑灌注短暂增加。脑氧合和灌注与神经发育结局无显著相关性。
