Year: 2026 | Month: September | Volume: 16 | Issue: 9 | Pages: 23-30
DOI: https://doi.org/10.52403/ijhsr.20260903
Association Between Cerebral Near-Infrared Spectroscopy and Magnetic Resonance Spectroscopy Findings in Neonates with Hypoxic-Ischemic Encephalopathy
Moumita Kundu1, Deepty Nauriyal2, Kamal Parihar3, Ajay Punj4
1Junior Resident, Department of Paediatrics, Subharti Medical College, Meerut.
2Associate Professor, Department of Paediatrics, Subharti Medical College, Meerut.
3Assistant Professor, Department of Pediatrics, Subharti Medical College, Meerut
4Professor and Head, Department of Paediatrics, Subharti Medical College, Meerut.
Corresponding Author: Moumita Kundu
ABSTRACT
Background: Hypoxic-ischemic encephalopathy (HIE) is an important cause of neonatal neurological morbidity and mortality. Early identification of cerebral injury is essential for clinical management and prognostication. Near-infrared spectroscopy (NIRS) provides continuous bedside assessment of cerebral oxygenation, whereas magnetic resonance spectroscopy (MRS) provides information on cerebral metabolic abnormalities. This study evaluated the association between cerebral oxygenation measured by NIRS and metabolic abnormalities detected by MRS in neonates with HIE.
Methods: This prospective hospital-based observational study included 38 neonates with HIE (Sarnat stages I–III) admitted to the neonatal intensive care unit of Chhatrapati Shivaji Subharti Hospital, Meerut, between July 2024 and February 2026. Cerebral regional oxygen saturation (rSO₂) was measured using NIRS at baseline, during hemodynamic monitoring/resuscitative management, and after fluid resuscitation. MRI/MRS was performed between 28 and 72 hours of life, and lactate peak, lactate/N-acetylaspartate (NAA) ratio, and NAA status were assessed. Continuous variables were summarized as mean ± standard deviation and categorical variables as frequencies and percentages. Between-group comparisons were performed using independent-samples t-tests, and binary logistic regression was used to evaluate the association between mean cerebral rSO₂ and lactate peak status.
Results: Of the 38 neonates, 30 (78.9%) required resuscitation and 18 (47.4%) had Sarnat stage II HIE. Mean cerebral rSO₂ was 63.3 ± 4.75% at baseline, decreased to 54.8 ± 8.97% during hemodynamic monitoring/resuscitation, and increased to 73.7 ± 3.35% after fluid resuscitation. Lactate peak and reduced NAA were observed in 30 (78.9%) neonates. Compared with neonates without a lactate peak, those with a lactate peak had lower baseline rSO₂ (61.5 ± 3.33% vs. 70.3 ± 2.12%; p<0.001), lower rSO₂ during monitoring/resuscitation (50.7 ± 4.29% vs. 70.3 ± 2.12%; p<0.001), and lower mean rSO₂ (62.0 ± 3.74% vs. 71.4 ± 2.05%; p<0.001). Mean cerebral rSO₂ was associated with lactate peak status (OR=2.95, 95% CI: 1.21–7.17; p=0.017).
Conclusion: Cerebral NIRS parameters were associated with MRS-detected metabolic abnormalities in neonates with HIE. NIRS may have potential as an adjunctive bedside monitoring modality; however, larger studies are required to validate these findings and determine its prognostic utility.
Key words: Hypoxic-Ischemic Encephalopathy; Near-Infrared Spectroscopy; Magnetic Resonance Spectroscopy; Cerebral Oxygenation; Neonatal brain injury, Lactate/NAA ratio.