Al-Lawama Manar, Kitaneh Razi, Smadi Zina, Alhammouri Ahmad, Al-Sanouri Mohammad, Almudallal Farah, Alfryjat Dyala, Al-Tarawneh Lubna, Elayan Hasan, Darraj Jaafar, Al-Ammouri Iyad
Department of Pediatrics, School of Medicine, The University of Jordan, Amman, JOR.
Department of Psychiatry, Yale School of Medicine, Yale Univeristy, New Haven, USA.
Cureus. 2025 Jul 12;17(7):e87787. doi: 10.7759/cureus.87787. eCollection 2025 Jul.
Background Pulse oximetry is a vital tool for screening critical congenital heart disease (CCHD) in newborns. However, fixed thresholds may not account for physiological variations caused by altitude. This study evaluates the impact of elevation on normal neonatal oxygen saturation (SpO₂) in Jordan, spanning sites from moderate altitude to below sea level. Methods In a cross-sectional study, 149 healthy, full-term newborns were screened at three hospitals located at 1,050 m (Amman), sea level (Aqaba), and 420 m below sea level (Dead Sea). Preductal and postductal SpO₂ measurements were taken between 24 and 72 hours of life using standardized protocols. Statistical analyses, including analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD), were used to compare SpO₂ levels across altitudes. Results Mean upper-limb SpO₂ was significantly lower at 1,050 m (96.6%) compared to sea level (98.0%) and sub-sea level (97.8%) (p < 0.001). Similar trends were observed for lower-limb SpO₂. No significant differences were found between sea-level and sub-sea-level sites. Despite lower SpO₂ at moderate altitude, no newborns met the American Academy of Pediatrics (AAP) criteria for CCHD. Conclusion Moderate altitude results in a statistically significant, but modest, reduction in neonatal SpO₂, potentially increasing false-positive rates in CCHD screening. Our findings support the development of altitude-specific screening protocols to improve diagnostic accuracy and reduce unnecessary interventions. Further research with larger and more diverse populations is needed to inform altitude-adjusted guidelines, particularly in geographically varied regions like Jordan.
脉搏血氧饱和度测定法是筛查新生儿重症先天性心脏病（CCHD）的重要工具。然而，固定阈值可能无法解释海拔引起的生理变化。本研究评估了海拔高度对约旦正常新生儿血氧饱和度（SpO₂）的影响，研究地点涵盖从中海拔到海平面以下的区域。
在一项横断面研究中，对位于海拔1050米（安曼）、海平面（亚喀巴）和海平面以下420米（死海）的三家医院的149名健康足月儿进行了筛查。在出生后24至72小时内，使用标准化方案测量了导管前和导管后的SpO₂。采用方差分析（ANOVA）和Tukey真实显著差异（HSD）等统计分析方法比较不同海拔高度的SpO₂水平。
与海平面（98.0%）和海平面以下（97.8%）相比，海拔1050米处的平均上肢SpO₂显著降低（96.6%）（p < 0.001）。下肢SpO₂也观察到类似趋势。海平面和海平面以下地点之间未发现显著差异。尽管中海拔地区的SpO₂较低，但没有新生儿符合美国儿科学会（AAP）的CCHD标准。
中等海拔导致新生儿SpO₂在统计学上有显著但适度的降低，这可能会增加CCHD筛查中的假阳性率。我们的研究结果支持制定针对特定海拔高度的筛查方案，以提高诊断准确性并减少不必要的干预措施。需要对更大、更多样化的人群进行进一步研究，以为海拔调整指南提供依据，特别是在约旦这样地理环境多样的地区。
