{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:08:42Z","timestamp":1779271722335,"version":"3.51.4"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Peripheral(-muscle) oxygenation assessed with near-infrared spectroscopy might serve as an early marker of infection\/inflammation; however, evidence of its clinical relevance is lacking so far. This study aimed to develop a peripheral(-muscle) oxygenation and perfusion score (POP-Score) using the peripheral(-muscle) tissue oxygenation index (pTOI) combined with non-invasive monitoring parameters within six hours after birth. The POP-Score was designed to explore associations with elevated C-reactive protein (CRP), as an early infection\/inflammation marker, in term and late-preterm neonates. Methods: Secondary outcome parameters from a prospective observational study were analysed. Included neonates weighed \u22652000 g with respiratory distress, excluding those with umbilical artery pH &lt; 7.20. Neonates with CRP \u2265 20 mg\/L were 1:4-matched to those with CRP &lt; 20 mg\/L by gestational age (\u00b12 weeks). For pTOI measurements, a sensor was placed for a duration of 30 s, followed by four further reapplications of the sensor, using the NIRO200NX within the first six hours after birth. The POP-Score was established using the following formula: (pTOI [%] \u00d7 subcutaneous fat layer thickness [cm] \u00d7 heart rate [bpm])\/(arterial oxygen saturation [%] \u00d7 systolic blood pressure [mmHg]). POP-Score was correlated with the highest CRP within 48 h. Results: Thirty neonates were included (median gestational age: 39.1 weeks [CRP &lt; 20 mg\/L group] vs. 37.3 weeks [CRP \u2265 20 mg\/L group], p = 0.299; median birth weight: 3561 g vs. 3260 g, p = 0.058, respectively). Median POP-Scores were significantly different: 1.11 (CRP \u2265 20 mg\/L) vs. 0.85 (CRP &lt; 20 mg\/L), p &lt; 0.001. POP-Score correlated positively with CRP (r = 0.341; p = 0.070). In this small exploratory cohort, a POP-Score cut-off of 1.00 was associated with CRP \u2265 20 mg\/L (100% sensitivity and 87% specificity); however, these estimates are uncertain due to the limited sample size. Conclusions: This study is the first to describe a new score for peripheral(-muscle) oxygenation and perfusion (POP-Score), which may represent a potential approach for early, non-invasive assessment but requires validation in adequately powered studies before any clinical application. Trial Registration: Clinicaltrials.gov, Trial registration number: NCT04818762, Date of Registration: 26 March 2021.<\/jats:p>","DOI":"10.3390\/diagnostics16101447","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:50:52Z","timestamp":1778496652000},"page":"1447","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Peripheral(-Muscle) Oxygenation and Perfusion Score (POP-Score): A New Non-Invasive Tool Associated with Elevations in C-Reactive Protein Levels in Neonates"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9770-3487","authenticated-orcid":false,"given":"Christina H.","family":"Wolfsberger","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schlatzer","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0220-5264","authenticated-orcid":false,"given":"Ena","family":"Suppan","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3429-7597","authenticated-orcid":false,"given":"Marlies","family":"Bruckner","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-2130","authenticated-orcid":false,"given":"Nina","family":"Hoeller","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-3712","authenticated-orcid":false,"given":"Bernhard","family":"Schwaberger","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2405-7143","authenticated-orcid":false,"given":"Gerhard","family":"Pichler","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/archdischild-2020-320217","article-title":"Global Incidence and Mortality of Neonatal Sepsis: A Systematic Review and Meta-Analysis","volume":"106","author":"Fleischmann","year":"2021","journal-title":"Arch. 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