Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study

PURPOSE: The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO(2)). Monitoring this process is of great importance. This study aimed to define the cSO(2) reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition. PATIENTS AND METHODS: A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation. RESULTS: We found that cSO(2) of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO(2) relative stabilization at 55.7–81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO(2) was maintained at 78.0–87.0%. The low cSO(2) rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively. CONCLUSION: We reported the trend in cSO(2) from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO(2) during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO(2) abnormalities in newborns when managing pregnant women with comorbidities.