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Multicenter Study
. 2025 Aug;45(8):1145-1151.
doi: 10.1038/s41372-024-02194-w. Epub 2024 Dec 11.

Association between 5-minute oxygen saturation and neonatal death and intraventricular hemorrhage among extremely preterm infants

Siyuan Jiang  1   2 , Xin Cui  3   4 , Anup Katheria  1   5 , Neil N Finer  1   5 , Mihoko V Bennett  3   4 , Jochen Profit  3   4 , Henry C Lee  6
Affiliations
Multicenter Study

Association between 5-minute oxygen saturation and neonatal death and intraventricular hemorrhage among extremely preterm infants

Siyuan Jiang et al. J Perinatol. 2025 Aug.

Abstract

Objective: To assess the relationship between 5-min oxygen saturation (SpO2) and outcomes in extremely preterm infants.

Study design: This cohort study included infants ≤28 weeks' gestation across nine hospitals from 2020 to 2022. Death and / or severe intraventricular hemorrhage (IVH) were compared between infants with 5-min SpO2 < 80% and 80-100% using Poisson regression models. Receiver Operating Characteristic (ROC) curve and optimal breakpoint analysis were used to estimate the optimal breakpoint of 5-min SpO2 in relation to outcomes.

Result: Of 390 infants, 184 (47.2%) had 5-min SpO2 < 80%. A 5-min SpO2 < 80% was independently associated with increased risks of death and / or severe IVH, early death, and severe IVH. ROC analysis of 5-min SpO2 identified optimal breakpoint at 81-85%, above which no additional benefit in outcomes was observed.

Conclusion: Our findings support the current recommendation of 5-min SpO2 target of ≥80% for extremely preterm infants.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All methods were performed in accordance with relevant guidelines and regulations. This data-only study was approved by the Institutional Review Board of Stanford University (protocol 1811082), with an exemption from the requirement for informed consent.

Figures

Fig. 1
Fig. 1
Distribution of 5-min SpO2 by gestational age among extremely preterm infants.
Fig. 2
Fig. 2. Association of predicted probability of death and / or severe intraventricular hemorrhage and 5-min SpO2.
A Crude predicted probability of death and / or severe IVH and 5-min SpO2. Scatter plot: Binary (1=yeas, 0=no) death and / or severe IVH by 5-min SpO2; Fitted lines with 95% confidence intervals. B Adjusted predicted probability of death and / or severe IVH and 5-min SpO2: An optimal breakpoint was identified at a 5-min SpO2 of 85%. Below this 85% threshold, the adjusted probability of death and / or severe IVH significantly decreased with increasing 5-min SpO2 (slope -5.1%, 95% CI (–6.1%, –4.2%), P value < 0.001); while above 85%, the adjusted probability of death and / or severe IVH was not significantly associated with 5-min SpO2 (slope 0.7%, 95% CI (–1.7%, 3.1%), P value = 0.572). Scatter plot: Predicted probability of death and / or severe IVH by 5-min SpO2; Fitted lines with 95% confidence intervals.
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References

    1. Perlman JM, Wyllie J, Kattwinkel J, Atkins DL, Chameides L, Goldsmith JP, et al. Part 11: Neonatal resuscitation: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122:S516–538. - PubMed
    1. Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: Neonatal resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S543–560. - PubMed
    1. Wyckoff MH, Wyllie J, Aziz K, de Almeida MF, Fabres J, Fawke J, et al. Neonatal life support: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2020;142:S185–S221. - PubMed
    1. Mariani G, Dik PB, Ezquer A, Aguirre A, Esteban ML, Perez C, et al. Pre-ductal and post-ductal O2 saturation in healthy term neonates after birth. J Pediatr. 2007;150:418–21. - PubMed
    1. Dawson JA, Kamlin CO, Vento M, Wong C, Cole TJ, Donath SM, et al. Defining the reference range for oxygen saturation for infants after birth. Pediatrics. 2010;125:e1340–1347. - PubMed

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