Effect of Intrauterine Growth Restriction on Cerebral Regional Oxygen Saturation in Preterm and Term Neonates during Immediate Postnatal Transition

Baik‐Schneditz, Nariae; Pichler, Gerhard; Schwaberger, Bernhard; Binder‐Heschl, Corinna; Mileder, Lukas P.; Reiss, Irwin K H; Avian, Alexander; Greimel, Patrick; Klaritsch, Philipp; Urlesberger, Berndt

doi:10.1159/000507583

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…Postnatally, neonates who experienced IUGR have persistent vasodilation of cerebral vasculature ( 94 ). This can result in higher ScO 2 values by NIRS likely due to a combination of increased cerebral oxygen delivery and a decreased cerebral tissue oxygen consumption ( 95 ). The key factor in using this technique is to not rely soley on the single timepoint measurement; rather, a trend in CPR is required to determine where on the trajectory a fetus is in regard to CA.…”

Section: Cerebral Blood Flow In Vulnerable Fetal and Neonatal Populationsmentioning

confidence: 99%

Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations

et al. 2022

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Cerebrovascular pressure autoregulation promotes stable cerebral blood flow (CBF) across a range of arterial blood pressures. Cerebral autoregulation (CA) is a developmental process that reaches maturity around term gestation and can be monitored prenatally with both Doppler ultrasound and magnetic resonance imaging (MRI) techniques. Postnatally, there are key advantages and limitations to assessing CA with Doppler ultrasound, MRI, and near-infrared spectroscopy. Here we review these CBF monitoring techniques as well as their application to both fetal and neonatal populations at risk of perturbations in CBF. Specifically, we discuss CBF monitoring in fetuses with intrauterine growth restriction, anemia, congenital heart disease, neonates born preterm and those with hypoxic-ischemic encephalopathy. We conclude the review with insights into the future directions in this field with an emphasis on collaborative science and precision medicine approaches.

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Section: Cerebral Blood Flow In Vulnerable Fetal and Neonatal Populationsmentioning

confidence: 99%

Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations

et al. 2022

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“…Our finding of higher cerebral rSO2 values in IUGR term neonates is in accordance with cerebral oxygenation data in IUGR preterm infants where higher values have been consistently reported in the first days after birth 26 , 27 . Recently, Baik-Schneditz et al also showed significantly higher cerebral rSO2 values and lower rates of oxygen extraction during the first 15 min after birth in IUGR preterm and term neonates when compared with AGA peers 28 . In regard to cerebral oxygen extraction, we found that IUGR infants had a decreased cerebral FTOE after birth.…”

Section: Discussionmentioning

confidence: 94%

Impact of intrauterine growth restriction on cerebral and renal oxygenation and perfusion during the first 3 days after birth

Montaldo

Puzone

Caredda

et al. 2022

Sci Rep

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Intrauterine growth restriction (IUGR) is associated with a higher incidence of perinatal complications as well as cardiovascular and renal diseases later on. A better insight into the disease mechanisms underlying these sequalae is important in order to identify which IUGR infants are at a higher risk and find strategies to improve their outcome. In this prospective case–control study we examined whether IUGR had any effect on renal and cerebral perfusion and oxygen saturation in term neonates. We integrated near-infrared spectroscopy (NIRS), echocardiographic, Doppler and renal function data of 105 IUGR infants and 105 age/gender-matched controls. Cerebral and renal regional oxygen saturation values were measured by NIRS during the first 12 h after birth. Echocardiography alongside Doppler assessment of renal and anterior cerebral arteries were performed at 6, 24, 48 and 72 h of age. Glomerular and tubular functions were also assessed. We found a left ventricular dysfunction together with a higher cerebral oxygen saturation and perfusion values in the IUGR group. IUGR term infants showed a higher renal oxygen saturation and a reduced oxygen extraction together with a subclinical renal damage, as indicated by higher values of urinary neutrophil gelatinase-associated lipocalin and microalbumin. These data suggest that some of the haemodynamic changes present in growth-restricted foetuses may persist postnatally. The increased cerebral oxygenation may suggest an impaired transition to normal autoregulation as a consequence of intra-uterine chronic hypoxia. The higher renal oxygenation may reflect a reduced renal oxygen consumption due to a subclinical kidney damage.

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“…This is consistent with Baik-Schneditz's research that an intrauterine growth restriction group did show significantly higher cSO 2 values. 32 The abnormal high cerebral oxygen levels might cause oxidative stress and cell damage in oxygensensitive organs, such as the developing brain. 32 Therefore, anesthesiologists should pay attention to the risk of neonatal cerebral oxygen abnormalities when managing anesthesia in a pregnant mother with comorbidities, such as PIH.…”

Section: Discussionmentioning

confidence: 99%

“…32 The abnormal high cerebral oxygen levels might cause oxidative stress and cell damage in oxygensensitive organs, such as the developing brain. 32 Therefore, anesthesiologists should pay attention to the risk of neonatal cerebral oxygen abnormalities when managing anesthesia in a pregnant mother with comorbidities, such as PIH. In contrast, decreases in BP were shown to poorly correlate with decreases in relative cSO 2 levels, which were comparable to the findings of 2 previous studies.…”

Section: Discussionmentioning

confidence: 99%

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

Xue¹,

Wu²,

Yao³

et al. 2020

DDDT

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Purpose The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO 2 ). Monitoring this process is of great importance. This study aimed to define the cSO 2 reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition. Patients and Methods A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation. Results We found that cSO 2 of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO 2 relative stabilization at 55.7–81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO 2 was maintained at 78.0–87.0%. The low cSO 2 rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively. Conclusion We reported the trend in cSO 2 from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO 2 during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO 2 abnormalities in newborns when managing pregnant women with comorbidities.

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Effect of Intrauterine Growth Restriction on Cerebral Regional Oxygen Saturation in Preterm and Term Neonates during Immediate Postnatal Transition

Cited by 10 publications

References 27 publications

Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations

Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations

Impact of intrauterine growth restriction on cerebral and renal oxygenation and perfusion during the first 3 days after birth

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

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