Neonatology最新文献

{"title":"Neonatal Sequential Organ Failure Assessment Score: A Reliable Tool for Predicting Outcomes in Neonates with Early-Onset Sepsis.","authors":"Bablu Kumar Gaur, Nivisha Jain","doi":"10.1159/neo/adsag008","DOIUrl":"10.1159/neo/adsag008","url":null,"abstract":"<p><strong>Introduction: </strong>The nSOFA score has been validated in late-onset sepsis. However, evidence regarding its performance in early-onset sepsis (EOS) remains limited. This study evaluated the utility of the nSOFA score for predicting mortality in neonates with EOS.</p><p><strong>Methods: </strong>This single-center prospective study was conducted on neonates with EOS admitted to the neonatal intensive care unit. The nSOFA score included respiratory function (SpO₂/FiO₂ ratio and ventilation need), cardiovascular status (inotropes or shock), and platelet count. All neonates were monitored for the need for respiratory support, inotropes, and corticosteroids, as well as for the presence and severity of thrombocytopenia. This score was assessed at three time points: at admission (T₀), 24 h, and 48 h.</p><p><strong>Results: </strong>A total of 110 neonates with culture-proven EOS were analyzed. The median gestational age was 35 weeks, mean birth weight was 2,054 g, and 78.2% were preterm. Overall mortality was 23.6% (n = 26). Non-survivors had significantly higher nSOFA scores at all time points (p < 0.001). The area under the curve for mortality prediction was 0.977 at baseline, 0.992 at 24 h, and 0.998 at 48 h. Severe thrombocytopenia, birth weight <1,500 g, mechanical ventilation, baseline nSOFA >7.5, and a rise in nSOFA ≥2 points were independently associated with mortality (p < 0.001). An nSOFA cut-off ≥7.5 (Youden index J = 0.887) showed 92.3% sensitivity and 96.4% specificity for predicting mortality.</p><p><strong>Conclusion: </strong>The nSOFA score reliably predicts mortality in neonates with EOS and demonstrates consistent performance across all assessed time points.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanosensitive Piezo Channels Modulate Airway Hyper-Reactivity in a Mouse Model of Neonatal CPAP.","authors":"Shannon L McAllister, Catherine A Mayer, Panvathu Rungsiyaphornratana, Peter Gallagher, Thomas M Raffay, Kenneth E Remy, Christina M Pabelick, Y S Prakash, Richard J Martin, Peter M MacFarlane","doi":"10.1159/neo/adsag005","DOIUrl":"10.1159/neo/adsag005","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous positive airway pressure (CPAP) is a preferred respiratory support modality for preterm infants. Animal studies have shown long-term detrimental effects on lung/airway development such as airway hyper-reactivity (AHR) may be an unfortunate consequence of sustained stretch associated with neonatal CPAP. The objective of the present study is to investigate the role of the mechanosensitive Piezo2 (PZ2) channel as a potential mediator of AHR and airway smooth muscle (ASM) morphology using our neonatal mouse model.</p><p><strong>Methods: </strong>Neonatal mice were fitted with a custom-made mask for delivery of daily CPAP consisting of 3 h/day for 7 consecutive days. At postnatal day 21 (2 weeks after CPAP ended), AHR and smooth muscle expression were assessed with and without modulation of PZ.</p><p><strong>Results: </strong>CPAP-induced AHR was prevented by acute PZ2-specific and nonspecific (PZ1 and PZ2) antagonist administration. AHR was associated with increased ASM, which was reduced by siRNA treatment targeting PZ2.</p><p><strong>Conclusions: </strong>These data suggest the long-term effects of CPAP on airway function involve mechanosensitive PZ channels, which could contribute to wheezing disorders in former preterm infants who had received prior CPAP administration.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Hemodynamic Data in an Ovine Model to Estimate Optimal Time for Compressor Change during Neonatal Resuscitation.","authors":"Evan M Giusto, Payam Vali, Deepika Sankaran, Erin Riley, Michelle J Lim, Amy Lesneski, Rebecca Valdez, Morgan Hardie, Victoria L Hammitt, Sylvia Bowditch, Jessa Rose Amora Li, Evan Maher, Satyan Lakshminrusimha","doi":"10.1159/neo/adsag004","DOIUrl":"10.1159/neo/adsag004","url":null,"abstract":"<p><strong>Introduction: </strong>Survival from cardiac arrest is directly and consistently linked to the quality of chest compressions (CC). Although compressor fatigue is well established, neonatal resuscitation guidelines (NRP) do not offer specific recommendations on rotation intervals beyond suggesting provider changes every 2-5 min. By comparison, Pediatric Advanced Life Support recommends a strict 2-min rotation to prevent fatigue and maintain high-quality CC.</p><p><strong>Methods: </strong>Prospective observational data from resuscitation of asphyxiated cardiac-arrested neonatal lambs to evaluate changes in chest compression rate, blood pressure, carotid blood flow with duration of CC by a single compressor. Forty-one near-term lambs were asphyxiated by umbilical cord occlusion until asystole resuscitated using NRP's synchronized three CC to one ventilation algorithm.</p><p><strong>Results: </strong>The error rate of providing >3 or <3 CC between ventilations was <1%. The CC rate and the percentage of lambs that received NRP's goal CC rate of 90/min decreased over time (p < 0.005). After 91-120 s of chest compressions, CC rate decreased by 4% [3%,6%], carotid flow decreased by 21% [7%,35%], systolic blood pressure decreased by 3.1 [1.1,5.0] mm Hg or 10% [3%,16%], and mean blood pressure decreased by 1.0 [0.3,1.7] or 7% [2%,12%] at the 95% confidence interval compared to baseline CC during the first 30 s (p < 0.05).</p><p><strong>Conclusions: </strong>Extended duration of CC beyond 2 min is associated with a decrease in carotid blood flow, CC rate, systolic and mean arterial blood pressure. To maintain optimal cerebral perfusion in an ovine model of cardiac arrest, rotating compressors every 2 min may minimize fatigue-induced decrease in CC efficacy.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Antenatal Corticosteroid Therapy on Women with Clinical Chorioamnionitis: A Nationwide Cohort Study in Japan.","authors":"Kana Saito, Hiroyuki Furuya, Atsushi Uchiyama, Fumihiko Namba","doi":"10.1159/000553390","DOIUrl":"10.1159/000553390","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal corticosteroids (ACSs) prevent neonatal complications and mortality in women at risk of preterm birth. However, the benefits and risks of ACS in chorioamnionitis (CAM) remain debated. This study evaluated whether ACS in women with clinical CAM was associated with adverse neonatal outcomes.</p><p><strong>Methods: </strong>This population-based retrospective study included neonates born before 34 weeks of gestation to women with clinical CAM in Japan between April 2010 and March 2023. Data were obtained from the Neonatal Research Network of Japan database. Adjusted odds ratios (aORs) for mortality and morbidity were compared between ACS and non-ACS groups.</p><p><strong>Results: </strong>Of the 6,158 preterm infants born to mothers with clinical CAM, 4,086 (66.4%) received ACS and 2,072 (33.6%) did not. ACS exposure was associated with reduced aORs for respiratory distress syndrome (RDS; aOR: 0.85; 95% confidence interval [CI]: 0.75-0.96), intraventricular hemorrhage (IVH) grade III/IV (aOR: 0.52; 95% CI: 0.41-0.66), periventricular leukomalacia (PVL; aOR: 0.71; 95% CI: 0.54-0.95), sepsis (aOR: 0.78; 95% CI: 0.66-0.92), treated retinopathy of prematurity (ROP; aOR: 0.81; 95% CI: 0.69-0.95), and mortality (aOR: 0.69; 95% CI: 0.55-0.87). In contrast, the aOR for bronchopulmonary dysplasia (BPD) was higher in the ACS group (aOR: 1.51; 95% CI: 1.31-1.73).</p><p><strong>Conclusion: </strong>ACS treatment in women with clinical CAM was associated with reduced neonatal death, RDS, severe IVH, PVL, sepsis, and ROP while increasing the risk of BPD. These findings support ACS therapy while underscoring the need for further studies to identify interventions beyond ACS to prevent BPD.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ophthalmic Antibiotic Prophylaxis as a Target for Antibiotic Stewardship: A Point Prevalence Multicentre Survey on Practices, Guideline Adherence, and Incidence of Ophthalmia Neonatorum within the European Society for Paediatric Research Network.","authors":"Cinzia Auriti, Giulia Iacona, Vito Mondì, Domenico Di Lallo, Anlaug Vatne, Fiammetta Piersigilli, Eric Giannoni, María Cernada, Kirsten Glaser, Katarzyna Wróblewska-Seniuk, Claus Klingenberg, Lise Aunsholt, Christoph Härtel, Helmut Küster, Flavia Rosa-Mangeret, Katarina Matasova, Laura Timelli, Chryssoula Tzialla, Salvatore Aversa, Edit Molnar, Maria Rosaria Gualano, Emiliano Maiani, Andrea Dotta, Domenico Umberto De Rose","doi":"10.1159/000553328","DOIUrl":"10.1159/000553328","url":null,"abstract":"<p><strong>Introduction: </strong>Ophthalmia neonatorum (ON) is a serious neonatal eye infection, primarily caused by Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (NG). Although the World Health Organization (WHO) recommends universal antibiotic prophylaxis at birth, many high-resource countries have suspended this procedure. European data on incidence of ON and prophylaxis use are limited.</p><p><strong>Aims: </strong>The aims of this study were to evaluate the routine implementation of prophylaxis across a selected sample of European birth centres, assess adherence to WHO recommendations, and estimate the incidence of conjunctivitis caused by CT and NG among newborns, comparing centres with and without prophylaxis.</p><p><strong>Methods: </strong>An electronic questionnaire was distributed to 94 birth centres in 21 European countries, focusing on those with significant birth volumes and university or referral hospital status. Data collection occurred over 2 days, November 20-21, 2024, with cases of CT/NG conjunctivitis reported for 2023.</p><p><strong>Results: </strong>Among 94 responding centres, 54 (57.5%) routinely implemented prophylaxis, but 74% of them did not adhere to WHO guidelines. Of 1,636 newborns observed, 598 (36.6%) received prophylaxis at birth. Seventeen cases of CT/NG conjunctivitis were reported in 2023, with similar incidence rates in centres with and without prophylaxis (6.2 vs. 5.8 per 100,000 live births; p = 0.89).</p><p><strong>Conclusions: </strong>Variations in ocular prophylaxis across involved centres, coupled with low rates of NG and CT conjunctivitis and no significant differences between centres using or not using prophylaxis, suggest that this practice could inform antibiotic stewardship in newborns. A unified, evidence-based European protocol is essential to enhance safety and reduce early antibiotic use.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality in Multiple versus Singleton Very Low Birth Weight Infants in Germany: A Population-Based Study.","authors":"Fabienne Kühne, Vinzenz Boos, Christoph Bührer","doi":"10.1159/000553215","DOIUrl":"10.1159/000553215","url":null,"abstract":"<p><strong>Introduction: </strong>In several large cohorts from the USA and China, multiple as opposed to singleton birth was found to be associated with increased mortality, while studies from European countries have yielded conflicting results. We aimed to assess the association between plurality and survival of very low birth weight infants in relation to gestational age.</p><p><strong>Methods: </strong>Data of preterm infants <1,500 g birth weight obtained from annually published quality improvement data mandatorily collected from all hospitals in Germany (2010-2017, 2019-2024) were analyzed for mortality of singletons versus multiples.</p><p><strong>Results: </strong>Among infants below 1,500 g birth weight (n = 128,057), twins and higher-order multiples accounted for 28.2% and 3.9%, as opposed to 3.5% and 0.1% in all neonates (n = 9,986,821). Mortality prior to discharge was lower in twins (7.3%) and triplets (6.2%) than in singletons (9.0%) (relative risk [RR] 0.811, 95% confidence interval [CI] 0.777-0.846, and 0.689 [0.618-0.769], respectively). However, in infants below 25 weeks' gestation, mortality was higher in multiples (40.5%) than in singletons (37.6%) (RR [95% CI] 1.076 [1.031-1.124]), whereas it was lower in multiples than in singleton infants with a gestational age of 25-27 weeks (8.5% vs. 9.4%, RR [95% CI] 0.907 [0.837-0.983]), 28-30 weeks (2.1% vs. 2.9%, RR [95% CI] 0.737 [0.650-0.835]), and more than 30 weeks (1.2% vs. 2.0%, RR [95% CI] 0.583 [0.484-0.703]).</p><p><strong>Conclusions: </strong>In this large population-based cohort of preterm infants below 1,500 g birth weight, multiples had higher survival rates than singletons, except those born before 25 weeks' gestation.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Peripheral Catheters in Neonates - Procedural Burden and Predictors of Complications: A Prospective Cohort Study.","authors":"Anna Tomaszkiewicz, Joanna Sosnowska, Karolina Jezierska, Piotr Szymański, Piotr Kruczek, Tomasz Krupa, Karolina Wróbel, Piotr Ptak, Boris W Kramer, Jan Mazela","doi":"10.1159/neo/adsag001","DOIUrl":"10.1159/neo/adsag001","url":null,"abstract":"<p><strong>Introduction: </strong>Short peripheral catheters (SPCs) are the most frequently used vascular access devices in neonatal care. However, prospective data quantifying the procedural burden of SPC use and identifying predictors of complications in term and preterm infants remain limited.</p><p><strong>Methods: </strong>In this prospective cohort study, 170 neonates undergoing SPC insertion during the first 7 days of life were included. A total of 354 cannulation procedures were recorded. The primary outcome was the occurrence of at least one SPC-related complication. Procedural burden was assessed using descriptive and exposure-adjusted analyses, and predictors of complications were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>First-attempt success was achieved in only 30.6% of infants, and the median number of attempts required per patient was 3 (range 1-23). At least one complication occurred in 66.5% of neonates. In multivariable analysis day of life at first cannulation, more than one insertion attempt, and parenteral nutrition were independently associated with complications.</p><p><strong>Conclusion: </strong>SPC use in neonates was associated with substantial procedural burden and frequent complications. Importantly, this burden was not confined to the most immature infants, but was also pronounced in moderate and late preterm neonates. These findings suggest that a routine peripheral-first strategy may not always be appropriate in this group and support earlier consideration of alternative vascular access strategies.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central venous catheter use is associated with reduced growth velocity and delayed enteral feeding in very low birth weight infants.","authors":"Anne Grimm, Jana Retzmann, Pia Paul, Eric Frieauff, Katharina Ruf, Stefanie Kampmeier, Michael Zemlin, Kirsten Glaser, Ingmar Fortmann, Wolfgang Göpel, Egbert Herting, Christoph Härtel, Christine Silwedel","doi":"10.1159/000553365","DOIUrl":"https://doi.org/10.1159/000553365","url":null,"abstract":"<p><strong>Introduction: </strong>Central venous catheters (CVCs) are widely used in preterm infants. They secure vascular access, but their value for nutrition and neonatal outcome remains uncertain.</p><p><strong>Methods: </strong>Within the German Neonatal Network (GNN) cohort, we evaluated data of very low birth weight infants (VLBWI) <29 weeks' gestation with and without CVCs. Associations between CVC use, growth, enteral feeding advancement, and duration of hospitalization were assessed using univariate and multivariate regression models. A survey among all German tertiary level neonatal intensive care units additionally assessed nutrition practices.</p><p><strong>Results: </strong>Among 12,516 infants, 82% received CVCs. Infants with CVCs had a lower mean gestational age (26.28 vs. 27.46 weeks, p<0.001) and birth weight (821 vs. 1,002g, p<0.001) compared to those without CVCs. In adjusted analyses, CVC use was associated with reduced neonatal weight gain (β -0.219 [CI -0.424 to -0.015], p=0.036) and head growth (β -0.040 [-0.054 to -0.025], p<0.001), delayed full enteral feeding (β 4.446 [3.820 to 5.071], p<0.001), and prolonged hospitalization (β 0.412 [0.376 to 0.449], p<0.001).</p><p><strong>Conclusion: </strong>Within the limits of an observational design, CVC utilization was associated with reduced growth, delayed full enteral feeding, and prolonged hospitalization in VLBWI. While findings should be interpreted in the context of differences in immaturity and morbidity between groups, they may contribute to further evaluation of current nutritional strategies, including routine CVC use for early-life parenteral nutrition, as well as more individualized approaches to nutritional management and careful consideration of CVC indications in VLBWI.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappraising the Evidence for Term-Equivalent Age MRI Superiority in Preterm Infants.","authors":"Mehmet N Cizmeci, Frances M Cowan, Linda S de Vries","doi":"10.1159/000553523","DOIUrl":"10.1159/000553523","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal Changes in Fetal Hemoglobin and Tissue Oxygenation in Preterm and Term Neonates: A Prospective Observational Study.","authors":"Ena Suppan, Thomas Suppan, Bernhard Schwaberger, Christina H Wolfsberger, Nariae Baik-Schneditz, Daniel Pfurtscheller, Christoph Schlatzer, Melina Winkler, Gerhard Pichler","doi":"10.1159/000553520","DOIUrl":"10.1159/000553520","url":null,"abstract":"<p><strong>Introduction: </strong>Physiological postnatal changes in fetal hemoglobin fraction (FHbF) may affect neonatal tissue oxygenation through shifts in the oxyhemoglobin dissociation curve. We examined cross-sectional associations between FHbF and near-infrared spectroscopy (NIRS)-derived tissue oxygenation, and longitudinal associations between within-infant changes in FHbF and cerebral tissue oxygenation (cStO₂) and oxygen extraction (cFTOE) during the first 3 postnatal weeks in neonates without red blood cell transfusions.</p><p><strong>Methods: </strong>This prospective observational study included 25 preterm (median [IQR] gestational age 33.6 [1.6] weeks) and 25 term (39.9 [1.4] weeks) neonates in a tertiary-center neonatal unit. Measurements were performed at T1 (days 2-3), T2 (days 5-10), and T3 (days 12-18). cStO₂ was assessed by time-resolved NIRS, peripheral tissue oxygenation by spatially resolved NIRS and peripheral fractional oxygen extraction by venous occlusion. cFTOE was calculated. Total hemoglobin (Hb) and FHbF were measured by co-oximetry. Cross-sectional associations were assessed using Spearman's rho correlations. Longitudinal trajectories and gestational age-adjusted within-infant change-on-change associations were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>No significant cross-sectional correlations were identified between FHbF and cerebral or peripheral NIRS-derived variables at any time point. Over time, Hb and cStO₂ declined, cFTOE increased, while peripheral oxygenation and extraction remained stable. Within-infant Hb changes were not associated with concurrent cerebral NIRS changes. In contrast, FHbF change was associated with change in cStO₂ (T2-T1: β per 1% FHbF, -0.19; 95% CI -0.33 to -0.05) and cFTOE (β 0.22; 95% CI 0.06-0.38).</p><p><strong>Conclusion: </strong>Within-infant FHbF decline was associated with increased cStO₂ and decreased cFTOE, independent of total Hb.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}