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

Background: 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(2)).Methods: This cross-sectional study included 110 preterm infants born at a gestational age (GA) of <32 weeks, or with a birth weight (BW) of <1,500 g at our institution between January and June 2,022. The rcSO(2) 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(2) measurements were analyzed using a cross-sectional research method.Results We divided the study population into two groups, with a mean rcSO(2) value over the first 14 days. Fifty-three preterm had rcSO(2) >= 55% and 57% < 55%. The 14-days-mean in the study population showing an association of lower rcSO(2) values with higher RDW values. Significantly higher RDW values were observed in the low rcSO(2) group compared with those in the high rcSO(2) group. Threshold effect analysis showed that rcSO(2) decreased with RDW values >= 18% (beta, -0.03; 95% CI, -0.04 and -0.02; p >= 0.0001). After adjusting for potential confounders, an RDW of >= 18% was determined as the predictive cutoff value for preterm infants with low rcSO(2) (Model I: OR, 3.31; 95% CI, 1.36-8.06; p = 0.009; and Model II: OR, 3.31; 95% CI, 1.28-8.53; p = 0.013).Conclusions An RDW of >= 18% in the first 14 days is associated with rcSO2 of <55% in preterm infants.