Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates

Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of F...

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Main Authors: Christina Helene Wolfsberger, Marlies Bruckner, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Peter Mileder, Alexander Avian, Berndt Urlesberger, Gerhard Pichler
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-07-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fped.2020.00401/full
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author Christina Helene Wolfsberger
Christina Helene Wolfsberger
Marlies Bruckner
Marlies Bruckner
Nariae Baik-Schneditz
Nariae Baik-Schneditz
Bernhard Schwaberger
Bernhard Schwaberger
Lukas Peter Mileder
Lukas Peter Mileder
Alexander Avian
Berndt Urlesberger
Berndt Urlesberger
Gerhard Pichler
Gerhard Pichler
author_facet Christina Helene Wolfsberger
Christina Helene Wolfsberger
Marlies Bruckner
Marlies Bruckner
Nariae Baik-Schneditz
Nariae Baik-Schneditz
Bernhard Schwaberger
Bernhard Schwaberger
Lukas Peter Mileder
Lukas Peter Mileder
Alexander Avian
Berndt Urlesberger
Berndt Urlesberger
Gerhard Pichler
Gerhard Pichler
author_sort Christina Helene Wolfsberger
collection DOAJ
description Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality.Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups.Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3–33.0) weeks; median IL-6 19.7 (IQR 12.2–37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4–33.1) weeks; IL-6: 5.4 (3.0–6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups.Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS.
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spelling doaj.art-1306bd6277564687a78c45a33c31039b2022-12-21T22:27:09ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-07-01810.3389/fped.2020.00401550163Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm NeonatesChristina Helene Wolfsberger0Christina Helene Wolfsberger1Marlies Bruckner2Marlies Bruckner3Nariae Baik-Schneditz4Nariae Baik-Schneditz5Bernhard Schwaberger6Bernhard Schwaberger7Lukas Peter Mileder8Lukas Peter Mileder9Alexander Avian10Berndt Urlesberger11Berndt Urlesberger12Gerhard Pichler13Gerhard Pichler14Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaInstitute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaIntroduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality.Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups.Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3–33.0) weeks; median IL-6 19.7 (IQR 12.2–37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4–33.1) weeks; IL-6: 5.4 (3.0–6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups.Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS.https://www.frontiersin.org/article/10.3389/fped.2020.00401/fullpreterm neonatesfetal inflammatory response syndrome (FIRS)inflammationinterleukin-6cerebral oxygenationnear-infrared spectroscopy (NIRS)
spellingShingle Christina Helene Wolfsberger
Christina Helene Wolfsberger
Marlies Bruckner
Marlies Bruckner
Nariae Baik-Schneditz
Nariae Baik-Schneditz
Bernhard Schwaberger
Bernhard Schwaberger
Lukas Peter Mileder
Lukas Peter Mileder
Alexander Avian
Berndt Urlesberger
Berndt Urlesberger
Gerhard Pichler
Gerhard Pichler
Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
Frontiers in Pediatrics
preterm neonates
fetal inflammatory response syndrome (FIRS)
inflammation
interleukin-6
cerebral oxygenation
near-infrared spectroscopy (NIRS)
title Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
title_full Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
title_fullStr Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
title_full_unstemmed Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
title_short Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates
title_sort fetal inflammatory response syndrome and cerebral oxygenation during immediate postnatal transition in preterm neonates
topic preterm neonates
fetal inflammatory response syndrome (FIRS)
inflammation
interleukin-6
cerebral oxygenation
near-infrared spectroscopy (NIRS)
url https://www.frontiersin.org/article/10.3389/fped.2020.00401/full
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