Neonatal Intensive Care Unit, IRCCS AOU S. Orsola, Via Massarenti 13-40138, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Eur J Pediatr. 2022 Oct;181(10):3711-3714. doi: 10.1007/s00431-022-04578-6. Epub 2022 Aug 4.
This observational study aimed to investigate whether predischarge cerebral oxygenation (CrSO), monitored by near-infrared spectroscopy, correlates with later psychomotor outcome in very preterm infants. Infants <32 weeks' gestation or <1500 g without evidence of major brain lesions underwent a 3-h continuous CrSO monitoring before hospital discharge. Psychomotor development was assessed at 6, 12, 18, and 24 months using the Griffiths Mental Developmental Scales. The developmental quotients (DQ) at each follow-up appointment were correlated with predischarge CrSO. Significant correlations were adjusted for possible confounders. Sixty-three infants were enrolled. A significant correlation between CrSO and DQ was observed at 6 months ca (p=0.010), but not at later psychomotor assessments. This correlation was confirmed significant (b=0.274, p=0.038) even after the adjustment for relevant covariates. Conclusion: According to these preliminary findings, the association between predischarge CrSO and psychomotor development over the first 24 months in preterm infants without major brain lesions is time-limited. Hence, this parameter may not represent an effective predictor for medium-term neurodevelopment. What is Known: • Prematurity is a major risk factor for adverse neurodevelopment. • The validation of clinical tools for psychomotor outcome prediction may aid to identify high-risk preterm infants who might benefit from early interventions. What is New: • In infants without major brain lesions, predischarge CrSO correlates with psychomotor outcome at 6 months ca but not later, indicating a short time predictability.
这项观察性研究旨在探讨通过近红外光谱监测的预出院脑氧合（CrSO）是否与极早产儿出院后的精神运动结局相关。没有证据表明存在主要脑损伤的<32 周龄或<1500g 的婴儿在出院前接受了 3 小时的连续 CrSO 监测。精神运动发育在 6、12、18 和 24 个月时使用 Griffiths 精神发育量表进行评估。每个随访时的发育商（DQ）与预出院 CrSO 相关。对可能的混杂因素进行了调整后，对显著相关性进行了调整。共纳入 63 名婴儿。在 6 个月 ca 时，CrSO 与 DQ 之间存在显著相关性（p=0.010），但在随后的精神运动评估中则没有。即使在对相关协变量进行调整后，这种相关性仍然显著（b=0.274，p=0.038）。结论：根据这些初步发现，在没有主要脑损伤的早产儿中，预出院 CrSO 与 24 个月内的精神运动发育之间的关联是有限的。因此，该参数可能无法代表中期神经发育的有效预测指标。已知的是：•早产儿是不良神经发育的主要危险因素。•验证用于预测精神运动结局的临床工具可能有助于识别可能受益于早期干预的高危早产儿。新的发现是：•在没有主要脑损伤的婴儿中，预出院 CrSO 与 6 个月 ca 时的精神运动结局相关，但与后期无关，表明其预测时间较短。
