AUTHOR=Mu Yuju , Wang Hua , Tian Mengting , Hu Yong , Feng Yi , Lu Ruifeng , He Qi , Jiang Shouliang , Huang Jinglan , Duan Surong , Mu Dezhi 

TITLE=Cross-sectional association between red blood cell distribution width and regional cerebral tissue oxygen saturation in preterm infants in the first 14 days after birth

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1238762

DOI=10.3389/fped.2023.1238762

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>Hypoxia can threaten the metabolic functions of different systems in immature neonates, particularly the central nervous system. The red blood cell distribution width (RDW) has recently been reported as a prognostic factor in neurologic diseases. Herein, we examined the correlation between RDW and regional cerebral tissue oxygen saturation (rcSO<sub>2</sub>).</p></sec><sec><title>Methods</title><p>This cross-sectional study included 110 preterm infants born at a gestational age (GA) of &lt;32 weeks, or with a birth weight (BW) of &lt;1,500<bold> </bold>g at our institution between January and June 2,022. The rcSO<sub>2</sub> was monitored using near-infrared spectroscopy, and RDW was extracted from the complete blood count during the first 14 days after birth. RDW and rcSO<sub>2</sub> measurements were analyzed using a cross-sectional research method.</p></sec><sec><title>Results</title><p>We divided the study population into two groups, with a mean rcSO<sub>2</sub> value over the first 14 days. Fifty-three preterm had rcSO<sub>2 </sub>≥<sub> </sub>55% and 57%<sub> </sub>&lt;<sub> </sub>55%. The 14-days-mean in the study population showing an association of lower rcSO<sub>2</sub> values with higher RDW values. Significantly higher RDW values were observed in the low rcSO<sub>2</sub> group compared with those in the high rcSO<sub>2</sub> group. Threshold effect analysis showed that rcSO<sub>2</sub> decreased with RDW values ≥18% (β, −0.03; 95% CI, −0.04 and −0.02; <italic>p</italic><sub> </sub>≥<sub> </sub>0.0001). After adjusting for potential confounders, an RDW of ≥18% was determined as the predictive cutoff value for preterm infants with low rcSO<sub>2</sub> (Model I: OR, 3.31; 95% CI, 1.36–8.06; <italic>p</italic><sub> </sub>=<sub> </sub>0.009; and Model II: OR, 3.31; 95% CI, 1.28–8.53; <italic>p</italic><sub> </sub>=<sub> </sub>0.013).</p></sec><sec><title>Conclusions</title><p>An RDW of ≥18% in the first 14 days is associated with rcSO<sub>2</sub> of &lt;55% in preterm infants.</p></sec>