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Treatment-by-gender effect when aiming to avoid hyperoxia in preterm infants in the NICU
Richard Deulofeut1, Golde Dudell, Augusto Sola
1Emory University School of Medicine, Division of Neonatal-Perinatal Medicine, Atlanta, Georgia, USA. deulofeut@post.harvard.edu
Insights
Avoiding high oxygen saturation (SpO2) levels benefits female infants more than males, with no increased short-term risks observed for either gender. This study highlights gender-specific responses in very low birth weight infants to oxygen therapy.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Neonatal Intensive Care
Background:
- Hyperoxia, or excessive oxygen exposure, is a concern in the management of very low birth weight (VLBW) infants.
- Previous studies suggest potential risks associated with hyperoxia, but gender-specific responses are not well understood.
- Oxygen saturation (SpO2) targets are crucial for balancing the need for oxygenation with the avoidance of hyperoxia.
Purpose of the Study:
- To investigate potential gender-specific differences in the response of VLBW infants to targeted SpO2 levels designed to prevent hyperoxia.
- To evaluate the impact of a lower SpO2 target range (85-93%) compared to a higher range (alarms at 92-100%) on infant outcomes.
- To assess whether changes in SpO2 targets affect short-term neurological morbidity differently between male and female infants.
Main Methods:
- Analysis of a prospectively collected database of VLBW infants (<1250 g) from two perinatal centers.
- Comparison of outcomes between two periods: Period I (January 2000-December 2002) with high SpO2 alarms at 100% and low alarms at 92%, and Period II (January 2003 onwards) with a target SpO2 of 85-93% to avoid hyperoxia.
- Statistical analysis of gender-specific rates of retinopathy of prematurity, bronchopulmonary dysplasia, length of stay, and short-term neurological morbidity.
Main Results:
- A total of 497 VLBW infants were analyzed.
- In Period II, targeting lower SpO2 levels (85-93%) showed significantly better outcomes for female infants compared to males regarding retinopathy of prematurity, bronchopulmonary dysplasia, and length of hospital stay, when compared to Period I.
- No significant differences in short-term neurological morbidity were observed between genders in response to the adjusted SpO2 targets.
Conclusions:
- Avoiding high SpO2 levels and hyperoxia demonstrates a significant gender-specific benefit favoring female VLBW infants.
- The implementation of lower SpO2 targets to prevent hyperoxia did not result in increased short-term detrimental effects for either gender.
- These findings suggest that individualized or gender-aware approaches to oxygen management in VLBW infants may be warranted.
Objective:
To examine gender-specific differences in response to the O(2) saturation (SpO(2)) targets aimed at avoiding hyperoxia in very low birth weight infants (VLBW).
Methods:
Analysis of a prospectively collected database of all infants
Results:
Of the 497 infants that met enrolment criteria, 297 (60%) were born during period I and 140 (47%) of them were male. During period II, 200 infants were born and 101 (50%) were male. Analysis by gender showed that the rate of retinopathy of prematurity, bronchopulmonary dysplasia and length of stay is significantly better for female infants than males on period II compared to period I. Neither gender experienced increased short-term neurological morbidity in response to lower SpO(2) targets.
Conclusions:
There is a significant gender-specific difference favouring females in the beneficial effects produced by avoiding high SpO(2) and hyperoxia, with no difference in the distribution of any potential short-term detrimental effects.
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