Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls

Objective1st: To determine the association of cerebral oxygenation (rcSO2) and concurrent neurodevelopmental outcomes between neonates with congenital heart disease (CHD) and healthy controls. 2nd: To examine the association of cerebral fractional tissue oxygen extraction (FTOE) with concurrent neur...

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Main Authors: Nhu N. Tran, Anna Miner, Eniola Adeleke, Rene Phan, Ken M. Brady, Mary-Lynn Brecht, Philippe Friedlich, Geena Zhou, Vidya Rajagopalan, Bradley S. Peterson, Jodie K. Votava-Smith
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Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1482257/full
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author Nhu N. Tran
Nhu N. Tran
Nhu N. Tran
Anna Miner
Eniola Adeleke
Rene Phan
Ken M. Brady
Mary-Lynn Brecht
Philippe Friedlich
Philippe Friedlich
Geena Zhou
Vidya Rajagopalan
Vidya Rajagopalan
Bradley S. Peterson
Bradley S. Peterson
Jodie K. Votava-Smith
Jodie K. Votava-Smith
author_facet Nhu N. Tran
Nhu N. Tran
Nhu N. Tran
Anna Miner
Eniola Adeleke
Rene Phan
Ken M. Brady
Mary-Lynn Brecht
Philippe Friedlich
Philippe Friedlich
Geena Zhou
Vidya Rajagopalan
Vidya Rajagopalan
Bradley S. Peterson
Bradley S. Peterson
Jodie K. Votava-Smith
Jodie K. Votava-Smith
author_sort Nhu N. Tran
collection DOAJ
description Objective1st: To determine the association of cerebral oxygenation (rcSO2) and concurrent neurodevelopmental outcomes between neonates with congenital heart disease (CHD) and healthy controls. 2nd: To examine the association of cerebral fractional tissue oxygen extraction (FTOE) with concurrent neurodevelopmental outcomes in the two groups. 3rd: To evaluate how type and severity of CHD influenced the associations in our primary and secondary objectives.Study designOur secondary analysis included 137 neonates (74 with CHD and 63 healthy controls). We used linear regression models to examine the association of the predictors (i.e., cerebral oxygenation, FTOE, type and severity of CHD) with the percentage of abnormal neurobehavioral scores (outcome). The models included the main effects of group, rcSO2, and a rcSO2-by-group interaction (examined differences between groups) with covariates of postconceptional age at exam, sex, ethnicity, and preductal peripheral oxygen saturation on the percentage of abnormal neurobehavioral scores. We also performed separate regression models separately in each group. We used these models for the 2nd and 3rd objectives, replacing rcSO2 with FTOE and type and severity of CHD as predictors.ResultsNeonates with CHD had lower rcSO2 values (67% vs. 79%; p < 0.001) and higher FTOE values (0.27 vs. 0.19; p < 0.001) compared to healthy controls. The association of rcSO2 with the neurobehavioral scores significantly differed between groups (p = 0.004). In the CHD group, increased rcSO2 showed a trend toward better neurodevelopmental outcomes. However, increased rcSO2 associated significantly with poorer neurodevelopmental outcomes in the healthy group. Additionally, FTOE significantly differed between groups (p = 0.012). The CHD group showed a trend towards increased FTOE and poorer neurodevelopmental outcomes. Conversely, increased FTOE associated significantly with better neurodevelopmental outcomes in the healthy group.ConclusionsThe CHD and healthy neonates had significantly different associations of both rcSO2 and FTOE with the neurobehavioral scores. Our findings suggest that both increased and decreased rcSO2 and FTOE may negatively affect concurrent neurodevelopmental outcomes in neonates. Our findings also imply a critical range of rcSO2 values, where extreme oxygenation on either side may be harmful. Neonates with CHD and healthy controls may exhibit different neurodevelopmental responses to increased rcSO2 and FTOE due to differing metabolic demands.
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spelling doaj-art-5676c33f0746445abf76da1dc064d5cd2025-08-20T02:13:48ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-02-011310.3389/fped.2025.14822571482257Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controlsNhu N. Tran0Nhu N. Tran1Nhu N. Tran2Anna Miner3Eniola Adeleke4Rene Phan5Ken M. Brady6Mary-Lynn Brecht7Philippe Friedlich8Philippe Friedlich9Geena Zhou10Vidya Rajagopalan11Vidya Rajagopalan12Bradley S. Peterson13Bradley S. Peterson14Jodie K. Votava-Smith15Jodie K. Votava-Smith16Institute for the Developing Mind, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesFetal and Neonatal Institute, Division of Neonatology, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesKeck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesLurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United StatesSchool of Nursing, University of California, Los Angeles, CA, United StatesFetal and Neonatal Institute, Division of Neonatology, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDivision of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesInstitute for the Developing Mind, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesDepartment of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesDivision of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, United StatesObjective1st: To determine the association of cerebral oxygenation (rcSO2) and concurrent neurodevelopmental outcomes between neonates with congenital heart disease (CHD) and healthy controls. 2nd: To examine the association of cerebral fractional tissue oxygen extraction (FTOE) with concurrent neurodevelopmental outcomes in the two groups. 3rd: To evaluate how type and severity of CHD influenced the associations in our primary and secondary objectives.Study designOur secondary analysis included 137 neonates (74 with CHD and 63 healthy controls). We used linear regression models to examine the association of the predictors (i.e., cerebral oxygenation, FTOE, type and severity of CHD) with the percentage of abnormal neurobehavioral scores (outcome). The models included the main effects of group, rcSO2, and a rcSO2-by-group interaction (examined differences between groups) with covariates of postconceptional age at exam, sex, ethnicity, and preductal peripheral oxygen saturation on the percentage of abnormal neurobehavioral scores. We also performed separate regression models separately in each group. We used these models for the 2nd and 3rd objectives, replacing rcSO2 with FTOE and type and severity of CHD as predictors.ResultsNeonates with CHD had lower rcSO2 values (67% vs. 79%; p < 0.001) and higher FTOE values (0.27 vs. 0.19; p < 0.001) compared to healthy controls. The association of rcSO2 with the neurobehavioral scores significantly differed between groups (p = 0.004). In the CHD group, increased rcSO2 showed a trend toward better neurodevelopmental outcomes. However, increased rcSO2 associated significantly with poorer neurodevelopmental outcomes in the healthy group. Additionally, FTOE significantly differed between groups (p = 0.012). The CHD group showed a trend towards increased FTOE and poorer neurodevelopmental outcomes. Conversely, increased FTOE associated significantly with better neurodevelopmental outcomes in the healthy group.ConclusionsThe CHD and healthy neonates had significantly different associations of both rcSO2 and FTOE with the neurobehavioral scores. Our findings suggest that both increased and decreased rcSO2 and FTOE may negatively affect concurrent neurodevelopmental outcomes in neonates. Our findings also imply a critical range of rcSO2 values, where extreme oxygenation on either side may be harmful. Neonates with CHD and healthy controls may exhibit different neurodevelopmental responses to increased rcSO2 and FTOE due to differing metabolic demands.https://www.frontiersin.org/articles/10.3389/fped.2025.1482257/fullcerebral oxygenationneurobehaviorcongenital heart diseasecerebral oxygen extractionneonatesneurodevelopmental outcome
spellingShingle Nhu N. Tran
Nhu N. Tran
Nhu N. Tran
Anna Miner
Eniola Adeleke
Rene Phan
Ken M. Brady
Mary-Lynn Brecht
Philippe Friedlich
Philippe Friedlich
Geena Zhou
Vidya Rajagopalan
Vidya Rajagopalan
Bradley S. Peterson
Bradley S. Peterson
Jodie K. Votava-Smith
Jodie K. Votava-Smith
Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
Frontiers in Pediatrics
cerebral oxygenation
neurobehavior
congenital heart disease
cerebral oxygen extraction
neonates
neurodevelopmental outcome
title Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
title_full Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
title_fullStr Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
title_full_unstemmed Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
title_short Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
title_sort association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls
topic cerebral oxygenation
neurobehavior
congenital heart disease
cerebral oxygen extraction
neonates
neurodevelopmental outcome
url https://www.frontiersin.org/articles/10.3389/fped.2025.1482257/full
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