Cerebrovascular autoregulation in preterm fetal growth restricted neonates

Emily Cohen, Willem Baerts, Alexander Caicedo Dorado, Gunnar Naulers, Frank van Bel, Petra M A Lemmers

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation 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: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.
Original languageEnglish (US)
Pages (from-to)1
Number of pages6
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
DOIs
StatePublished - Oct 2018

Cite this

Cohen, Emily ; Baerts, Willem ; Caicedo Dorado, Alexander ; Naulers, Gunnar ; van Bel, Frank ; Lemmers, Petra M A. / Cerebrovascular autoregulation in preterm fetal growth restricted neonates. In: Archives of Disease in Childhood: Fetal and Neonatal Edition. 2018 ; pp. 1.
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abstract = "Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation 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: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95{\%} CI 0.11 to 0.18) vs 0.09 (95{\%} CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95{\%} CI 0.13 to 0.20) vs 0.09 (95{\%} CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19{\%} (95{\%} CI 16{\%} to 22{\%}) vs 14{\%} (95{\%} CI 12{\%} to 17{\%}), p=0.035) and day 3 (20{\%} (95{\%} CI 17{\%} to 24{\%}) vs 15{\%} (95{\%} CI 12{\%} to 18{\%}), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.",
author = "Emily Cohen and Willem Baerts and {Caicedo Dorado}, Alexander and Gunnar Naulers and {van Bel}, Frank and Lemmers, {Petra M A}",
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Cerebrovascular autoregulation in preterm fetal growth restricted neonates. / Cohen, Emily; Baerts, Willem; Caicedo Dorado, Alexander; Naulers, Gunnar; van Bel, Frank; Lemmers, Petra M A.

In: Archives of Disease in Childhood: Fetal and Neonatal Edition, 10.2018, p. 1.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cerebrovascular autoregulation in preterm fetal growth restricted neonates

AU - Cohen, Emily

AU - Baerts, Willem

AU - Caicedo Dorado, Alexander

AU - Naulers, Gunnar

AU - van Bel, Frank

AU - Lemmers, Petra M A

PY - 2018/10

Y1 - 2018/10

N2 - Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation 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: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.

AB - Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation 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: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.

U2 - 10.1136/archdischild-2017-313712

DO - 10.1136/archdischild-2017-313712

M3 - Article

C2 - 30355781

SP - 1

JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

JF - Archives of Disease in Childhood: Fetal and Neonatal Edition

SN - 1359-2998

ER -