Oxygen administration at birth in preterm infants: a retrospective analysis

Abstract

Objective: The aim of the study was to retrospectively investigate the association between initial oxygen concentration in delivery room and short-term outcomes in preterm infants.

Methods: Data from infants needing neonatal resuscitation, born at our department between January 2008 and December 2011, were analyzed. Patients were divided into three groups based on gestational age: between 32 and 36 weeks, between 31 and 28 weeks, and below 28 weeks.

Results: The administration of each additional unit of oxygen up to 50% showed an association with a 5% increased need for mechanical ventilation (MV) in the neonatal intensive care unit in infants between 32 and 36 weeks [adjusted odds ratio 1.1, 95% confidence interval (CI) 1.04–1.1] and infants between 28 and 31 weeks (adjusted odds ratio 1.12, 95% CI 1.08–1.44). On the contrary, in infants below 28 weeks, increasing initial concentration of supplementary oxygen did not show any association with MV.

Conclusions: Initial oxygen concentration seems to be associated with increased MV in the NICU. Our observations further stress the need for randomized controlled studies in order to obtain definitive recommendations for the optimal initial oxygen concentration during neonatal resuscitation of preterm infants.

• Guidelines
• mechanical ventilation
• neonatal resuscitation
• oxygen
• preterm

Acknowledgements

We thank Dr. Fabio Candotti, MD (National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA), Dr. Bernard Thébaud, MD, PhD (Professor of Pediatrics, Department of Pediatrics, Children’s Hospital of Eastern Ontario) and Dr. Stefano Ghirardello, MD (Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan) for the scientific revision of our manuscript. We thank Dr. Ashraf Kharrat, MD (Children Hospital of Eastern Ontario) the English revision of the manuscript.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.