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. 2024 Oct:273:114132.
doi: 10.1016/j.jpeds.2024.114132. Epub 2024 May 31.

Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm

Christina H Wolfsberger  1 , Bernhard Schwaberger  1 , Berndt Urlesberger  1 , Alexander Avian  2 , Katharina Goeral  3 , Marlene Hammerl  4 , Tina Perme  5 , Eugene M Dempsey  6 , Laila Springer  7 , Gianluca Lista  8 , Tomasz Szczapa  9 , Hans Fuchs  10 , Lukasz Karpinski  9 , Jenny Bua  11 , Brenda Law  12 , Julia Buchmayer  3 , Ursula Kiechl-Kohlendorfer  4 , Lilijana Kornhauser-Cerar  5 , Christoph E Schwarz  6 , Kerstin Gründler  7 , Ilaria Stucchi  8 , Katrin Klebermass-Schrehof  3 , Georg M Schmölzer  12 , Gerhard Pichler  13 ; COSGOD III study group
Collaborators, Affiliations

Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm

Christina H Wolfsberger et al. J Pediatr. 2024 Oct.

Abstract

Objective: To define percentile charts for arterial oxygen saturation (SpO2), heart rate (HR), and cerebral oxygen saturation (crSO2) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome.

Study design: We conducted a secondary-outcome analysis of neonates born preterm included in the Cerebral regional tissue Oxygen Saturation to Guide Oxygen Delivery in preterm neonates during immediate transition after birth III (COSGOD III) trial with visible cerebral oximetry measurements and with favorable outcome, defined as survival without cerebral injuries until term age. We excluded infants with inflammatory morbidities within the first week after birth. SpO2 was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. crSO2 was assessed with near-infrared spectroscopy. Measurements were performed during the first 15 minutes after birth. Percentile charts (10th to 90th centile) were defined for each minute.

Results: A total of 207 neonates born preterm with a gestational age of 29.7 (23.9-31.9) weeks and a birth weight of 1200 (378-2320) g were eligible for analyses. The 10th percentile of SpO2 at minute 2, 5, 10, and 15 was 32%, 52%, 83%, and 85%, respectively. The 10th percentile of HR at minute 2, 5, 10, and 15 was 70, 109, 126, and 134 beats/min, respectively. The 10th percentile of crSO2 at minute 2, 5, 20, and 15 was 15%, 27%, 59%, and 63%, respectively.

Conclusions: This study provides new centile charts for SpO2, HR, and crSO2 for neonates born extremely or very preterm with favorable outcome. Implementing these centiles in guiding interventions during the stabilization process after birth might help to more accurately target oxygenation during postnatal transition period.

Keywords: arterial oxygen saturation; centile charts; cerebral oxygen saturation; heart rate; immediate neonatal transition; neonates born preterm; percentiles; reference ranges.

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Conflict of interest statement

Declaration of Competing Interest The COSGOD III trial received support from the Austrian Science Fund and the Health Research Board (HRB) Clinical Research Facility at the University of Cork for the submitted work and from the Stollery Children’s Hospital Foundation facilitated by the Women and Children’s Health Research Institute; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. The COSGOD III trial was funded by the Austrian Science Fund (Fonds zur Förderung der wissenschaftlichen Forschung [FWF] Austria) through an unconditional and unrestricted grant (KLI 586-B31). Health Research Board (HRB) Clinical Research Facility at University College Cork supported the study at the Infant Centre, University College Cork, Cork University Maternity Hospital, Cork, Ireland. G.S. was a recipient of the Heart and Stroke Foundation/University of Alberta Professorship of Neonatal Resuscitation, a National New Investigator of the Heart and Stroke Foundation Canada, and an Alberta New Investigator of the Heart and Stroke Foundation Alberta. This research was facilitated by the Women and Children’s Health Research Institute through the support of the Stollery Children’s Hospital Foundation. No funding was received for the analysis of the data presented in the submitted manuscript, and funders had no influence on analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors have no conflicts of interest relevant to this article.

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