Cerebral oxygenation in preterm infants

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P <.05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P <.05), and at 2 to 3 months when prone (P <.001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P <.01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.
Original languageEnglish
Pages (from-to)435 - 445
Number of pages11
JournalPediatrics
Volume134
Issue number3
DOIs
Publication statusPublished - 2014

Cite this

@article{843127d5b37a47b6a22375a8f97c1fef,
title = "Cerebral oxygenation in preterm infants",
abstract = "Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P <.05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P <.05), and at 2 to 3 months when prone (P <.001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P <.01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.",
author = "Karinna Fyfe and Stephanie Yiallourou and Wong, {Flora Yuen-Wait} and Alexsandria Odoi and Walker, {Adrian Mark} and Horne, {Rosemary Sylvia Claire}",
year = "2014",
doi = "10.1542/peds.2014-0773",
language = "English",
volume = "134",
pages = "435 -- 445",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "3",

}

Cerebral oxygenation in preterm infants. / Fyfe, Karinna; Yiallourou, Stephanie; Wong, Flora Yuen-Wait; Odoi, Alexsandria; Walker, Adrian Mark; Horne, Rosemary Sylvia Claire.

In: Pediatrics, Vol. 134, No. 3, 2014, p. 435 - 445.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cerebral oxygenation in preterm infants

AU - Fyfe, Karinna

AU - Yiallourou, Stephanie

AU - Wong, Flora Yuen-Wait

AU - Odoi, Alexsandria

AU - Walker, Adrian Mark

AU - Horne, Rosemary Sylvia Claire

PY - 2014

Y1 - 2014

N2 - Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P <.05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P <.05), and at 2 to 3 months when prone (P <.001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P <.01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.

AB - Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P <.05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P <.05), and at 2 to 3 months when prone (P <.001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P <.01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.

UR - http://www.ncbi.nlm.nih.gov/pubmed/25157010

U2 - 10.1542/peds.2014-0773

DO - 10.1542/peds.2014-0773

M3 - Article

VL - 134

SP - 435

EP - 445

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 3

ER -