Valles-Murcia Nerea, Solaz-García Álvaro, Pinilla-González Alejandro, Torrejón-Rodríguez Laura, Gormaz María, Escrig-Fernández Raquel, González-Timoneda Alba, Cernada María, Vento Máximo
Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain.
Department of Obstetrics and Gynecology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain.
Neonatology. 2025;122(2):161-170. doi: 10.1159/000542792. Epub 2024 Nov 23.
Moderate and late preterm (MLPT) infants represent a substantial percentage of all preterm infants and frequently need support in the delivery room. Deferred cord clamping (DCC) improves SpO2 and heart rate (HR) stabilization in term infants. However, data on MLPT infants are limited.
We performed a prospective observational study collecting SpO2 and HR by pulse oximetry in healthy MLPT infants with DDC to construct percentile graphs for the first 10 min after birth.
A total of 96 MLPT infants were monitored for preductal SpO2 and HR, and percentiles were calculated. SpO2 mean was significantly lower for MLPT than for term infants during the first 6 min after birth, and 15% did not achieve SpO2 ≥85% in the first 5 min after birth. HR was significantly lower in MLPT infants in the first 4 min after birth; however, HR consistently remained above bradycardic values (>100 bpm). NICU admission and postnatal complications were not different between MLPT achieving SpO2 ≥85% or not.
MLPT infants with DCC achieved stable SpO2 and HR significantly later, 6 min and 4 min, respectively, than term infants. In addition, 15% of MLPT infants did not achieve SpO2 ≥85% at 5 min after birth. However, admission to the NICU and clinical evolution did not differ from newborns with SpO2 ≥85% at 5 min. Larger studies including long-term follow-up are needed to assess if lower SpO2 in the first 5 min has clinical consequences in non-resuscitated MLPT.
中度和晚期早产儿（MLPT）占所有早产儿的很大比例，在产房经常需要支持。延迟脐带结扎（DCC）可改善足月儿的血氧饱和度（SpO2）和心率（HR）稳定情况。然而，关于MLPT婴儿的数据有限。
我们进行了一项前瞻性观察性研究，通过脉搏血氧饱和度仪收集健康的接受DCC的MLPT婴儿的SpO2和HR，以构建出生后前10分钟的百分位图。
共监测了96例MLPT婴儿的导管前SpO2和HR，并计算了百分位数。出生后头6分钟内，MLPT婴儿的SpO2平均值显著低于足月儿，15%的婴儿在出生后前5分钟内未达到SpO2≥85%。出生后头4分钟内，MLPT婴儿的HR显著较低；然而，HR一直保持在心动过缓值以上（>100次/分钟）。达到或未达到SpO2≥85%的MLPT婴儿在新生儿重症监护病房（NICU）入院率和产后并发症方面没有差异。
接受DCC的MLPT婴儿达到稳定的SpO2和HR的时间分别比足月儿显著延迟，分别为6分钟和4分钟。此外，15%的MLPT婴儿在出生后5分钟时未达到SpO2≥85%。然而，NICU入院情况和临床进展与出生后5分钟时SpO2≥85%的新生儿没有差异。需要进行包括长期随访的更大规模研究，以评估出生后前5分钟较低的SpO2在未复苏的MLPT中是否具有临床后果。
