WIP 66 - Cerebral Near-Infrared Spectroscopy Trajectories in Infants Born 22-24 Weeks Gestation and the Impact of Prenatal Risk Factors and Clinical Course

Poster Number: WIP 66
Publication Number: WIP 66.2630

Background: Cerebral near-infrared spectroscopy (cNIRS) monitoring is a noninvasive tool used in neonatal intensive care units (NICUs) to continuously monitor cerebral regional tissue oxygen saturation (rScO2). Extremely preterm infants are at a high risk of adverse neurological sequelae due to their inability to autoregulate fluctuations in cerebral blood flow, increasing their risk of neurological injury. Little is known about cNIRS trajectories in infants 22-24 6/7 weeks’ gestational age (GA), and the association of pre- and post-natal variables and physiologic hemodynamics in conjunction with cNIRS with adverse outcomes.

Objective: We aim to generate reference curves for rScO2 stratified by GA obtained via continuous cNIRS monitoring of infants born between 22 0/7 - 24 6/7 weeks’ GA. We also aim to describe the association between prenatal risk factors, clinical characteristics, and rScO2 readings and their correlation with in-hospital mortality and morbidity, including neurologic injury and neurodevelopmental outcomes.

Design/Methods: This is an observational study of infants born at 22 0/7 - 24 6/7 weeks’ GA and/or < 500g at a Level IV NICU monitored with cNIRS on admission. Variables will be extracted from the electronic medical record and neurodevelopmental database. Clinical events will be retrospectively aligned in time-series with rScO2. We will use linear mixed model analysis to generate reference curves of rScO2 over the first 72-hours of life stratified by GA followed by multiple regression analysis to assess the influence of demographics, prenatal risk factors, postnatal hemodynamics, and clinical course on rScO2, adjusting for baseline characteristics. Lastly, we will use multiple regression analysis to evaluate associations between rScO2 and adverse in-hospital outcomes such as mortality and morbidity, including IVH and neurodevelopmental outcomes at 12 months corrected GA.

Timeline: Project is IRB approved. A HIPAA-compliant data collection file has been created and variables are being extracted (50% complete). Anticipated completion of analysis 1/1/2024.