Oral or Poster Presentation
Concurrent Session 3D - Neo Neurosciences & Neuro Critical Care
Introduction: Infants born 29-36 weeks’ gestational age (GA) represent the majority of preterm births and are at increased risk of developmental delay. Early identification of preterm infants who would benefit the most from specialized neurodevelopmental follow-up is needed. We hypothesize that cerebral blood flow and metabolism monitored by advanced near infrared spectroscopy (NIRS) are valid biomarkers of cerebral development and associated with the neuromotor status at term-equivalent age (TEA) in preterm infants.
Methods: Preterm infants (n=85) born 29-36 weeks’ GA and admitted in the neonatal intensive care unit were consecutively recruited in this single-center prospective observational cohort study. Advanced NIRS was performed from one week post-birth to TEA, with a neuromotor exam at TEA. Measures of indices of cerebral blood flow (CBFi) and cerebral metabolic rate of oxygen consumption (CMRO2i) were derived from advanced NIRS. We examined the relationship between changes in advanced NIRS parameters over time and the neuromotor status using logistic regression analysis.
Results: Mean GA was 33.4±1.8 weeks, mean birthweight was 1877±595g, 52% were males, 35% were multiples, 76% were exposed to antenatal steroids and 46% had urgent C-section. At TEA, 33 infants (39%) had an abnormal neuromotor exam. After data quality assessment, 48 and 26 had at least two valid measures to calculate change in CBFi and CMRO2i, respectively. Higher GA was associated with steeper CBFi (β=0.49; P<0.001) and CMRO2i (β=0.56; P=0.003) slopes. Adjusting for GA, neither CBFi (OR 1.27; 95% CI 0.31-5.15) nor CMRO2i (OR 0.30; 95% CI 0.05-1.91) were associated with neuromotor exam at TEA.
Conclusion: In this population, cerebral parameters did not correlate with infant neuromotor status at TEA. Gestational age was significantly associated with more rapid increase in cerebral blood flow and oxygen metabolism. Whether these new biomarkers of cerebral development predict later neurodevelopment will be assessed as this cohort grows older.