Cerebral Oximetry Monitoring Shows No Outcome Benefit in Preterm Infants: Study

A new research published in the Journal of the American Medical Association revealed that among extremely preterm infants, cerebral oximetry–guided treatment during the first 72 hours after birth did not reduce death or neurodevelopmental disability, nor did it improve cognitive outcomes at 2 years when compared to usual care. Therefore these findings do not support the routine use of cerebral oximetry monitoring for improving long-term outcomes in this population.

Extremely preterm infants (26 weeks of gestation), are highly vulnerable to brain injury due to unstable oxygen levels in the critical hours after birth. Here, cerebral oximetry has been viewed as an effective tool to help clinicians intervene earlier and potentially prevent damage.

The findings come from the phase 3 SafeBoosC-III trial, which involved 1,601 infants born across 70 hospitals in 17 countries. This research determined whether treatment guided by cerebral oximetry could reduce the risk of death or neurodevelopmental disability when compared to standard care.

The study combined clinical assessments, parental questionnaires, and observational data which were collected from 2021 to 2024. The follow-up data from 1,438 infants assessed at approximately two years of corrected age showed no meaningful differences between those who received oximetry-guided care and those who received usual treatment.

In the cerebral oximetry group, 47.1% of infants either died or developed moderate to severe neurodevelopmental disability, when compared with 48.0% in the standard care group. Likewise, cognitive outcomes measured using standardized Bayley developmental scores were nearly identical between the two groups, with average scores of 92.8 and 93.2 respectively.

The results reinforce earlier findings from the same trial, which showed no reduction in mortality or severe brain injury at 36 weeks’ postmenstrual age with the use of cerebral oximetry monitoring. This extended follow-up confirms that the lack of benefit persists into early childhood.

While the technology remains safe and non-invasive, this study finds that its routine use in the first 72 hours after birth cannot be justified as a strategy to improve long-term neurological outcomes in extremely preterm infants. Further research exploring whether specific subgroups of infants or different intervention thresholds could yield benefits is required.

Source:

Rasmussen, M. I. S., Hansen, M. L., Pellicer, A., Hyttel-Sørensen, S., Ergenekon, E., Szczapa, T., Hagmann, C., Naulaers, G., Mintzer, J., Fumagalli, M., Dimitriou, G., Dempsey, E., Tkaczyk, J., Fredly, S., Heuchan, A. M., Pichler, G., Fuchs, H., Nesargi, S., Hahn, G. H., Piris-Borregas, S., … Greisen, G. (2026). Cerebral Oximetry in Extremely Preterm Infants: 2-Year Follow-Up of the SafeBoosC-III Randomized Clinical Trial. JAMA pediatrics, e261066. Advance online publication. https://doi.org/10.1001/jamapediatrics.2026.1066