Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

Respir Physiol Neurobiol. 2022 Nov;305:103942. doi: 10.1016/j.resp.2022.103942. Epub 2022 Jun 28.


Background: Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants.

Methods: Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpO2) < 75% was measured from the nursing records, from admission to 36 weeks postmenstrual age in infants born < 30 weeks gestational age. The multiple deprivation index (MDI) and the main care giver's education domain of the MDI were also recorded.

Results: A total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9-29.0) weeks and a birth weight of 0.94(0.74-1.23) kg were analysed. The median (IQR) motor score [103(91-110)] was significantly related to the median (IQR) time with SpO2 < 75% [1.5(0.9-3.4)%, adjusted p = 0.020]. The median (IQR) cognitive score [100(90-105)] was negatively significantly related to the time with SpO2 < 75% (adjusted p = 0.012) and the median (IQR) education decile of the MDI [7(6-9), adjusted p = 0.011]. The median (IQR) language score [91(77-100)] was significantly positively related to the education domain of the MDI (adjusted p = 0.025).

Conclusions: Hypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.

Keywords: Neurodevelopmental outcomes; Prematurely born infants; Socioeconomic deprivation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development*
  • Gestational Age
  • Humans
  • Hypoxia
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Retrospective Studies
  • Socioeconomic Factors