Gonzales Gustavo F, Salirrosas Amelia
Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Av, Honorio Delgado 430, Urb, Ingenieria, Lima, Peru, PO Box 1843, Lima, Peru.
Reprod Biol Endocrinol. 2005 Sep 12;3:46. doi: 10.1186/1477-7827-3-46.
High altitude is associated with both low pulse oxygen saturation at birth and more pre-term deliveries. The present study was performed to determine pulse oxygen saturation in newborns at term in Cerro de Pasco (4340 m) and Lima (150 m) to test the hypothesis that low pulse oxygen saturation at birth at high altitudes was not observed at term deliveries.
The present study was designed to determine pulse oxygen saturation values through 1 minute to 24 hours and values of Apgar score at 1 and 5 minutes in newborns delivered at term in Cerro de Pasco (4340 m) and Lima (150 m). Pulse oxygen saturation was recorded in 39 newborns from Cerro de Pasco (4340 m) and 131 from Lima (150 m) at 1, 2, 3, 4, 5, 10, 15, 30 minutes and 1, 2, 8 and 24 hours after delivery. Apgar score was assessed at 1 and 5 minutes after birth. Neurological score was assessed at 24 h of birth by Dubowitz exam.
Pulse oxygen saturation increased significantly from 1 to 15 min after birth at sea level and from 1 to 30 minutes at Cerro de Pasco. Thereafter, it increased slightly such that at 30 min at sea level and at 60 minutes in Cerro de Pasco it reached a plateau up to 24 hours after birth. At all times, pulse oxygen saturation was significantly higher at sea level than at high altitude (P < 0.01). At 1 minute of life, pulse oxygen saturation was 15% lower at high altitude than at sea level. Apgar score at 1 minute was significantly lower at high altitude (P < 0.05). Neurological score at 24 hours was also lower at high altitude than at sea level. Head circumference, and Apgar score at 5 minutes were similar at sea level and at high altitude (P:NS). Incidence of low birth-weight (<2500 g) at high altitude (5.4%) was similar to that observed at sea level (2.29%) (P:NS). Incidences of low pulse oxygen saturation (<30%), low Apgar score at first minute (<7) and low neurological score at 24 h (<19) were significantly higher at high altitude than at sea level (P < 0.0001; P < 0.0001; and P < 0.001, respectively).
From these analyses may be concluded that pulse oxygen saturation at 4340 m was significantly low despite the fact that births occurred at term. Apgar scores at first minute and neurological scores were also lower at high altitudes.
高海拔地区与出生时低脉搏血氧饱和度及更多早产相关。本研究旨在测定塞罗德帕斯科(海拔4340米)和利马(海拔150米)足月新生儿的脉搏血氧饱和度,以检验在足月分娩时高海拔地区出生时低脉搏血氧饱和度未被观察到这一假设。
本研究旨在测定塞罗德帕斯科(海拔4340米)和利马(海拔150米)足月分娩新生儿出生后1分钟至24小时的脉搏血氧饱和度值以及1分钟和5分钟时的阿氏评分。记录了来自塞罗德帕斯科(海拔4340米)的39例新生儿和来自利马(海拔150米)的131例新生儿在出生后1、2、3、4、5、10、15、30分钟以及1、2、8和24小时的脉搏血氧饱和度。出生后1分钟和5分钟评估阿氏评分。出生后24小时通过杜波维茨检查评估神经学评分。
出生后海平面地区脉搏血氧饱和度在1至15分钟显著升高,塞罗德帕斯科地区在1至30分钟显著升高。此后,其略有升高,以至于在海平面地区出生后30分钟和塞罗德帕斯科地区出生后60分钟达到平台期直至出生后24小时。在所有时间点,海平面地区的脉搏血氧饱和度均显著高于高海拔地区(P<0.01)。出生1分钟时,高海拔地区的脉搏血氧饱和度比海平面地区低15%。高海拔地区1分钟时的阿氏评分显著更低(P<0.05)。高海拔地区24小时时的神经学评分也低于海平面地区。海平面地区和高海拔地区的头围以及5分钟时的阿氏评分相似(P:无显著性差异)。高海拔地区低出生体重(<2500克)的发生率(5.4%)与海平面地区观察到的发生率(2.29%)相似(P:无显著性差异)。高海拔地区低脉搏血氧饱和度(<30%)、出生后第一分钟低阿氏评分(<7)和24小时时低神经学评分(<19)的发生率显著高于海平面地区(分别为P<0.0001;P<0.0001;和P<0.001)。
从这些分析中可以得出结论,尽管是足月分娩,但在海拔4340米处的脉搏血氧饱和度仍显著较低。高海拔地区出生后第一分钟的阿氏评分和神经学评分也更低。