Article Text

THE BRAIN OF THE PRETERM NEWBORN IS HYPER-OXYGENATED COMPARED TO THE TERM NEWBORN
  1. L C Sorensen1,2,
  2. G Greisen2
  1. 1Department of Paediatrics and Neonatology, Copenhagen University Hospital, Hvidovre, Denmark
  2. 2Department of Neonatology, National University Hospital, Rigshospitalet, Copenhagen, Denmark

Abstract

Objective White matter damage in the newborn, preterm brain has elements of hypoxia-ischemia. Is the brain of the preterm newborn less “pink” compared to the brain of term newborn? The aim was to compare the cerebral oxygenation in the first day of life in preterm and term newborns.

Methods Forty-six preterms (GA<33) and 25 healthy, terms were included. Cerebral tissue oxygen saturation was measured using near-infrared spectroscopy (TOI, NIRO 300, Hamamatsu). The cerebral oxygenation was measured in steady state within the first day of life. The median age at NIRS was 19.2 hours.

Results The mean GA and BW were 29.1±2.6 vs. 39.7±1.3 and 1.307±437 g vs. 3.484±346 g, respectively. All term infants were healthy newborns from the maternity ward. Within the first 24 hours, three preterms needed mechanical ventilation and 11 inotropic drugs. Later three preterm infants developed intraventricular haemorrhage and one infant died. There was a significant difference in c-TOI: terms 74.7% [95% CI 72.3 to 77.1] vs. preterms 78.6% [95% CI 76.9 to 80.3]. There was no significant correlation between head size and c-TOI. The mean peripheral arterial saturation was 95% in both groups. The median blood pCO2 in the preterms was 6.1 kPa [3.4; 7.3].

Conclusion Compared to term newborns, the cerebral oxygenation on the first day of life during steady state was higher in stable, relatively healthy preterms. A slightly elevated blood pCO2 could be the explanation.

This work was supported by the Ludvig og Sara Elsass Foundation.

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