Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
J Pediatr. 2024 Oct;273:114132. doi: 10.1016/j.jpeds.2024.114132. Epub 2024 May 31.
To define percentile charts for arterial oxygen saturation (SpO), heart rate (HR), and cerebral oxygen saturation (crSO) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome.
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. SpO was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. crSO 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.
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 SpO 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 crSO at minute 2, 5, 20, and 15 was 15%, 27%, 59%, and 63%, respectively.
This study provides new centile charts for SpO, HR, and crSO 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.
为极早产儿和预后良好的早产儿出生后 15 分钟内的动脉血氧饱和度（SpO2）、心率（HR）和脑氧饱和度（crSO2）定义百分位图表。
我们对出生前接受了可见脑氧饱和度测量且预后良好的早产儿出生后立即过渡期间进行了脑区域性组织氧饱和度指导氧输送 III（COSGOD III）试验的次要结局分析，将其纳入研究，定义为无脑损伤直至足月龄的存活。我们排除了出生后第一周内患有炎症性疾病的婴儿。SpO2 通过脉搏血氧仪获得，HR 通过心电图或脉搏血氧仪测量。crSO2 通过近红外光谱评估。测量在出生后 15 分钟内进行。为每分钟定义了百分位数图表（第 10 到 90 百分位）。
共有 207 名极早产儿和非常早产儿（胎龄 29.7（23.9-31.9）周，出生体重 1200（378-2320）g）符合分析条件。第 2、5、10 和 15 分钟时 SpO2 的第 10 百分位数分别为 32%、52%、83%和 85%。第 2、5、10 和 15 分钟时 HR 的第 10 百分位数分别为 70、109、126 和 134 次/分。第 2、5、20 和 15 分钟时 crSO2 的第 10 百分位数分别为 15%、27%、59%和 63%。
本研究为预后良好的极早产儿和非常早产儿提供了 SpO2、HR 和 crSO2 的新百分位图表。在出生后稳定过程中实施这些百分位数来指导干预，可能有助于更准确地在新生儿过渡期靶向氧合。
