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Growth restriction and gender influence cerebral oxygenation in preterm neonates
  1. Emily Cohen1,2,
  2. Willem Baerts1,
  3. Thomas Alderliesten1,
  4. Jan Derks3,
  5. Petra Lemmers1,
  6. Frank van Bel1
  1. 1Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands
  2. 2The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
  3. 3Department of Obstetrics, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Emily Cohen, The Ritchie Centre, Hudson Institute of Medical Research, 27–31 Wright Street, Clayton, VIC 3002, Australia; Emily.cohen{at}monash.edu

Abstract

Objective To investigate the effect of fetal growth restriction and gender on cerebral oxygenation in preterm neonates during the first 3 days of life.

Design Case–control study.

Setting Neonatal Intensive Care Unit of the Wilhelmina Children's Hospital, The Netherlands.

Patients 68 (41 males) small for gestational age (SGA) (birth weight <10th percentile) and 136 (82 males) appropriate for gestational age (AGA) (birth weight 20th–80th percentile) neonates, matched for gender, gestational age, ventilatory and blood pressure support.

Methods Regional cerebral oxygen saturation (rScO2) and cerebral fractional tissue oxygen extraction (cFTOE) as measured by near-infrared spectroscopy throughout the first 72 h of life were compared between SGA and AGA neonates. The effect of gender was also explored within these comparisons.

Results SGA neonates demonstrated higher rScO2 (71% SEM 0.2 vs 68% SEM 0.2) and lower cFTOE (0.25 SEM 0.002 vs 0.29 SEM 0.002) than AGA neonates. There was an independent effect of gender on rScO2 and cFTOE, resulting in the finding that SGA males displayed highest rScO2 and lowest cFTOE (73% SEM 0.3 respectively 0.24 SEM 0.003). AGA males and SGA females showed comparable rScO2 (69% SEM 0.2 vs 69% SEM 0.4) and cFTOE (0.28 SEM 0.002 vs 0.28 SEM 0.004). AGA females showed lowest rScO2 and highest cFTOE (66% SEM 0.2 respectively 0.30 SEM 0.002).

Conclusions Growth restriction and gender influence cerebral oxygenation and oxygen extraction in preterm neonates throughout the first 3 days of life.

  • Small for gestational age (SGA)
  • Intrauterine growth restriction (IUGR)
  • Fetal growth restriction (FGR)
  • Near-infrared spectroscopy (NIRS)
  • Cerebral oxygenation

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