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Association of early cerebral oxygen saturation and brain injury in extremely preterm infants



To assess the association between cerebral saturation (crSO2) using Near-Infrared Spectroscopy (NIRS) and brain injury in extremely preterm infants.

Study design

This retrospective study includes 62 infants (<28 weeks gestation) who underwent continuous NIRS monitoring in the first 5 days after birth. Median crSO2 were compared in 12 h increments between infants with and without germinal matrix/intraventricular hemorrhage (GM/IVH). crSO2 was also compared by IVH severity, onset, and by grade of injury on term equivalent MRI.


After 48 h of life (HOL), infants with GM/IVH had significantly lower crSO2 than those without GM/IVH in analysis adjusted for potential confounding e.g., at 49–60 HOL (69.5 (66.2, 72.8) vs. 74.7 (71.8, 77.6), p = 0.023). There were no significant differences in crSO2 by IVH subcategory or injury severity on MRI.


Clinical use of NIRS has the potential to identify crSO2 patterns associated with development of GM/IVH.

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Fig. 1: Trajectories of %crSO2 (least square means and 95% CIs) over time by IVH status.
Fig. 2: Trajectories of %crSO2 (least square means and 95% CIs) over time by IVH status.
Fig. 3: Trajectories of crSO2 (least square means and 95% CIs) over time by Early/Late/No IVH status.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Authors and Affiliations



MED conceptualized and designed the study, drafted the initial paper, and reviewed and revised the paper. CM participated in research data acquisition, helped to draft the initial paper, and reviewed and revised the paper. JS assisted in data processing, helped to draft the initial paper, and reviewed and revised the paper. SC performed the statistical analyses, helped to draft the initial paper, and reviewed and revised the paper. SL, EH, and TS participated in research data acquisition and reviewed and revised the paper. KB, MAF, and JV provided guidance around the study design, and reviewed and revised the paper. TI helped to conceptualize and design the study and reviewed and revised the paper. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Mohamed El-Dib.

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Competing interests

MEl-D discloses he is the PI of an investigator-initiated research funded by Medtronic and served once on an advisory board for Radiometer but these are not related to this work. Other authors declare that they have no competing interests.

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El-Dib, M., Munster, C., Sunwoo, J. et al. Association of early cerebral oxygen saturation and brain injury in extremely preterm infants. J Perinatol 42, 1385–1391 (2022).

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