Background and aims Disturbed cerebral oxygenation during the neonatal period might pose preterm infants at risk for neurological deficits. Our aim was to determine whether regional cerebral tissue oxygen saturation (r_cSO₂) and fractional tissue oxygen extraction (FTOE), measured by near-infrared spectroscopy, were associated with neurodevelopmental outcome of preterm infants at 2–3 years of age.

Methods We included 83 preterm infants (gestational age< 32 weeks) and measured r_cSO₂, and calculated FTOE on days 1, 2, 3, 4, 5, 8, and 15 after birth: (tcSaO₂-r_cSO₂)/tcSaO₂. Additionally, we determined the area under the curve (AUC) of r_cSO₂ and FTOE during the first 2 weeks. Cognitive, motor, neurological and behavioural outcome was determined at 2–3 years of age. Multiple linear regression analyses were used to determine whether r_cSO₂ and FTOE contributed to outcome.

Results We included 67 infants for follow-up. Lower quartile (P_25–50) and highest quartile (P_75–100) of r_cSO₂ values on day 1 were associated with poorer cognitive outcome (p=0.044 and p=0.008, respectively). Lower AUC of r_cSO₂ was associated with poorer cognitive outcome (p=0.014). Lower quartile (P_25–50) AUC of r_cSO₂ was associated with poorer fine motor outcome (p=0.004). The amount of time r_cSO₂< 50% on day 1 was negatively associated with gross motor outcome (p=0.002). The highest quartile of FTOE values on day 1 was associated with poorer total motor outcome (p=0.041).

Conclusions Neurodevelopmental outcome at 2–3 years of age was associated with cerebral oxygen saturation during the first 2 weeks after birth in preterm infants. Both high and low r_cSO₂ values had a negative influence on neurodevelopmental outcome.