The increasing sum of Ductus Arteriosus (DA) and Foramen Ovale (FO) diameters were correlated negatively with cerebral oxygenation. Considering DA alone might be insufficient to obtain the whole picture regarding the influence of left to right shunting on cerebral oxygenation during neonatal transition. When DA and FO are present during neonatal transition, the positive effect of LR shunting via DA might be reduced by left to right steal phenomenon of combined LR shunting via FO and DA.