Introduction: The primary aim was to analyze any coupling of heart rate (HR)/arterial oxygen saturation (SpO2) and regional cerebral oxygen saturation (rScO2) and regional cerebral fractional tissue oxygen extraction (cFTOE) during immediate transition after birth in term and preterm neonates to gain more insight into interactions. Methods: The present study is a post hoc analysis of data from 106 neonates, obtained from a prospective, observational study. Measurements of HR, SpO2, rScO2, and cFTOE were performed during the first 15 min after birth. The linear and nonlinear correlation were computed between these parameters in a sliding window. The resulting coupling curves were clustered. After clustering, demographic data of the clusters were de-blinded and compared. Results: Due to missing data, 58 out of 106 eligible patients were excluded. Two clusters were obtained: cluster 1 (N = 39) and cluster 2 (N = 9). SpO2 had linear and nonlinear correlations with rScO2 and cFTOE, whereby the correlations with rScO2 were more pronounced in cluster 2. HR-rScO2 and HR-cFTOE demonstrated a nonlinear correlation in both clusters, again being more pronounced in cluster 2, whereby linear correlations were mainly absent. After de-blinding, the demographic data revealed that the neonates in cluster 2 had significantly lower gestational age (mainly preterm) compared to cluster 1 (mainly term). Discussion: Besides SpO2, also HR demonstrated a nonlinear correlation with rScO2 and cFTOE in term and preterm neonates during immediate transition after birth. In addition, the coupling of SpO2 and HR with cerebral oxygenation was more pronounced in neonates with a lower gestational age.

1.
Pichler
G
,
Binder
C
,
Avian
A
,
Beckenbach
E
,
Schmölzer
GM
,
Urlesberger
B
.
Reference ranges for regional cerebral tissue oxygen saturation and fractional oxygen extraction in neonates during immediate transition after birth
.
J Pediatr
.
2013
;
163
(
6
):
1558
63
.
2.
Pichler
G
,
Urlesberger
B
,
Baik
N
,
Schwaberger
B
,
Binder-Heschl
C
,
Avian
A
, et al
.
Cerebral oxygen saturation to guide oxygen delivery in preterm neonates for the immediate transition after birth: a 2-center randomized controlled pilot feasibility trial
.
J Pediatr
.
2016
;
170
:
73
8.e84
.
3.
Dawson
JA
,
Davis
PG
,
O’Donnell
CPF
,
Kamlin
COF
,
Morley
CJ
.
Pulse oximetry for monitoring infants in the delivery room: a review
.
Arch Dis Child Fetal Neonatal Ed
.
2007
;
92
(
1
):
F4
F7
. .
4.
Kamlin
COF
,
O’Donnell
CPF
,
Davis
PG
,
Morley
CJ
.
Oxygen saturation in healthy infants immediately after birth
.
J Pediatr
.
2006
;
148
(
5
):
585
9
.
5.
Rabi
Y
,
Yee
W
,
Chen
SY
,
Singhal
N
.
Oxygen saturation trends immediately after birth
.
J Pediatr
.
2006
;
148
(
5
):
590
4
.
6.
Chang
T
,
Du Plessis
A
.
Neurodiagnostic techniques in neonatal critical care
.
Curr Neurol Neurosci Rep
.
2012
;
12
(
2
):
145
52
.
7.
Schwaberger
B
,
Pichler
G
,
Binder-Heschl
C
,
Baik-Schneditz
N
,
Avian
A
,
Urlesberger
B
.
Cerebral blood volume during neonatal transition in term and preterm infants with and without respiratory support
.
Front Pediatr
.
2018
;
6
:
132
.
8.
Baik-Schneditz
N
,
Pichler
G
,
Schwaberger
B
,
Binder-Heschl
C
,
Mileder
L
,
Reiss
IKH
, et al
.
Effect of intrauterine growth restriction on cerebral regional oxygen saturation in preterm and term neonates during immediate postnatal transition
.
Neonatology
.
2020
;
117
(
3
):
324
30
.
9.
Baik
N
,
Urlesberger
B
,
Schwaberger
B
,
Schmölzer
GM
,
Mileder
L
,
Avian
A
, et al
.
Reference ranges for cerebral tissue oxygen saturation index in term neonates during immediate neonatal transition after birth
.
Neonatology
.
2015
;
108
(
4
):
283
6
.
10.
Urlesberger
B
,
Grossauer
K
,
Pocivalnik
M
,
Avian
A
,
Müller
W
,
Pichler
G
.
Regional oxygen saturation of the brain and peripheral tissue during birth transition of term infants
.
J Pediatr
.
2010
;
157
(
5
):
740
4
.
11.
Pichler
G
,
Schmölzer
GM
,
Urlesberger
B
.
Cerebral tissue oxygenation during immediate neonatal transition and resuscitation
.
Front Pediatr
.
2017
;
5
:
29
.
12.
Schwaberger
B
,
Pichler
G
,
Binder-Heschl
C
,
Baik
N
,
Avian
A
,
Urlesberger
B
.
Transitional changes in cerebral blood volume at birth
.
Neonatology
.
2015
;
108
(
4
):
253
8
.
13.
Baik
N
,
Urlesberger
B
,
Schwaberger
B
,
Schmölzer
GM
,
Avian
A
,
Pichler
G
.
Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter
.
Arch Dis Child Fetal Neonatal Ed
.
2015
;
100
(
5
):
F422
7
. .
14.
Wolfsberger
CH
,
Bruckner
M
,
Baik-Schneditz
N
,
Schwaberger
B
,
Mileder
LP
,
Avian
A
, et al
.
Fetal inflammatory response syndrome and cerebral oxygenation during immediate postnatal transition in preterm neonates
.
Front Pediatr
.
2020
;
8
:
401
.
15.
Pichler
G
,
Avian
A
,
Binder
C
,
Zotter
H
,
Schmölzer
GM
,
Morris
N
, et al
.
AEEG and NIRS during transition and resuscitation after birth: promising additional tools; an observational study
.
Resuscitation
.
2013
;
84
(
7
):
974
8
.
16.
Pichler
G
,
Cheung
PY
,
Aziz
K
,
Urlesberger
B
,
Schmölzer
GM
.
How to monitor the brain during immediate neonatal transition and resuscitation? A systematic qualitative review of the literature
.
Neonatology
.
2014
;
105
(
3
):
205
10
. .
17.
Rees
S
,
Harding
R
,
Walker
D
.
The biological basis of injury and neuroprotection in the fetal and neonatal brain
.
Int J Dev Neurosci
.
2011
;
29
(
6
):
551
63
.
18.
Rees
S
,
Inder
T
.
Fetal and neonatal origins of altered brain development
.
Early Hum Dev
.
2005
;
81
(
9
):
753
61
.
19.
Jary
S
,
Kmita
G
,
Wroblewska
J
,
Whitelaw
A
.
Quantitative cranial ultrasound prediction of severity of disability in premature infants with post-haemorrhagic ventricular dilatation
.
Arch Dis Child
.
2012
;
97
(
11
):
955
9
.
20.
Klebermass-Schrehof
K
,
Czaba
C
,
Olischar
M
,
Fuiko
R
,
Waldhoer
T
,
Rona
Z
, et al
.
Impact of low-grade intraventricular hemorrhage on long-term neurodevelopmental outcome in preterm infants
.
Child’s Nerv Syst
.
2012
;
28
(
12
):
2085
92
. .
21.
Kuperman
AA
,
Brenner
B
,
Kenet
G
.
Intraventricular hemorrhage in preterm infants and coagulation: ambivalent perspectives
.
Thromb Res
.
2013
;
131
(
Suppl 1
):
S35
8
.
22.
Gerstner
B
,
DeSilva
TM
,
Genz
K
,
Armstrong
A
,
Brehmer
F
,
Neve
RL
, et al
.
Hyperoxia causes maturation-dependent cell death in the developing white matter
.
J Neurosci
.
2008
;
28
(
5
):
1236
45
.
23.
Sorensen
LC
,
Greisen
G
.
The brains of very preterm newborns in clinically stable condition may Be hyperoxygenated
.
Pediatrics
.
2009
;
124
(
5
):
e958
63
.
24.
Blackburn
ST
.
Maternal, fetal & neonatal physiology: a clinical perspective
. 3rd.
St. Louis, MO
:
Elsevier
;
2007
.
25.
Naulaers
G
,
Meyns
B
,
Miserez
M
,
Leunens
V
,
Van Huffel
S
,
Casaer
P
, et al
.
Use of tissue oxygenation index and fractional tissue oxygen extraction as non-invasive parameters for cerebral oxygenation: a validation study in piglets
.
Neonatology
.
2007
;
92
(
2
):
120
6
.
26.
Mintzer
JP
,
Moore
JE
.
Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions
.
Pediatr Res
.
2019
;
86
(
3
):
296
304
.
27.
Tina
L
,
Frigiola
A
,
Abella
R
,
Artale
B
,
Puleo
G
,
D’Angelo
S
, et al
.
Near infrared spectroscopy in healthy preterm and term newborns: correlation with gestational age and standard monitoring parameters
.
Curr Neurovasc Res
.
2009
;
6
(
3
):
148
54
.
28.
Hunter
CL
,
Oei
JL
,
Lui
K
,
Schindler
T
.
Cerebral oxygenation as measured by near-infrared spectroscopy in neonatal intensive care: correlation with arterial oxygenation
.
Acta Paediatr
.
2017
;
106
(
7
):
1073
8
.
29.
Mitra
S
,
Czosnyka
M
,
Smielewski
P
,
O’Reilly
H
,
Brady
K
,
Austin
T
.
Heart rate passivity of cerebral tissue oxygenation is associated with predictors of poor outcome in preterm infants
.
Acta Paediatr
.
2014
;
103
(
9
):
e374
82
.
30.
Cimatti
AG
,
Martini
S
,
Galletti
S
,
Vitali
F
,
Aceti
A
,
Frabboni
G
, et al
.
Cerebral oxygenation and autoregulation in very preterm infants developing IVH during the transitional period: a pilot study
.
Front Pediatr
.
2020
;
8
:
381
.
31.
Zanelli
SA
,
Abubakar
M
,
Andris
R
,
Patwardhan
K
,
Fairchild
KD
,
Vesoulis
ZA
.
Early vital sign differences in very low birth weight infants with severe intraventricular hemorrhage
.
Am J Perinatol
.
2023
;
40
(
11
):
1193
201
.
32.
Wyllie
J
,
Bruinenberg
J
,
Roehr
CC
,
Rüdiger
M
,
Trevisanuto
D
,
Urlesberger
B
.
European Resuscitation Council Guidelines for Resuscitation 2015. Section 7. Resuscitation and support of transition of babies at birth
.
Resuscitation
.
2015
;
95
:
249
63
. .
33.
Bresesti
I
,
Avian
A
,
Bruckner
M
,
Binder-Heschl
C
,
Schwaberger
B
,
Baik-Schneditz
N
, et al
.
Impact of bradycardia and hypoxemia on oxygenation in preterm infants requiring respiratory support at birth
.
Resuscitation
.
2021
;
164
:
62
9
. .
34.
Janaillac
M
,
Beausoleil
TP
,
Barrington
KJ
,
Raboisson
MJ
,
Karam
O
,
Dehaes
M
, et al
.
Correlations between near-infrared spectroscopy, perfusion index, and cardiac outputs in extremely preterm infants in the first 72 h of life
.
Eur J Pediatr
.
2018
;
177
(
4
):
541
50
. .
35.
Baik-Schneditz
N
,
Schwaberger
B
,
Mileder
L
,
Höller
N
,
Avian
A
,
Urlesberger
B
, et al
.
Cardiac output and cerebral oxygenation in term neonates during neonatal transition
.
Children
.
2021
;
8
(
6
):
439
.
You do not currently have access to this content.