Related Experiment Video
Updated: May 19, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Oxygenation of the newborn: a molecular approach
Ola Didrik Saugstad1, Yngve Sejersted, Rønnaug Solberg
1Department of Pediatric Research, Women and Children's Division, Oslo University Hospital, University of Oslo, Oslo, Norway. odsaugstad@rr-research.no
Insights
Newborn infants require careful oxygen management to prevent hyperoxic injury. Current guidelines suggest using air for resuscitation and titrating oxygen levels to avoid DNA damage and potential cancer risks.
Area of Science:
- Neonatal medicine
- Molecular biology
- Genetics
Background:
- Review of oxygenation and hyperoxic injury in newborn infants at molecular and genetic levels.
- Exploration of protection and repair mechanisms against oxidative stress in neonates.
- Basis for reduced oxygen supplementation and oxidative load in newborns since 2000.
Discussion:
- Mechanisms linking hyperoxic resuscitation to DNA damage and impaired repair.
- Increased risk of carcinogenicity due to oxidative stress in newborns.
- Current recommendations for resuscitation: air for term infants, titrated oxygen (21-30%) for preterm infants.
Key Insights:
- Optimal oxygen saturation targets for preterm infants in the postnatal period are still under investigation.
- Postnatal oxygen saturation should be targeted below 95%, but levels between 85-89% may increase mortality.
- Evidence supports using air instead of 100% oxygen for term infant resuscitation.
Outlook:
- Further research needed to determine optimal postnatal oxygen saturation targets for preterm infants.
- Potential for novel therapeutic strategies targeting protection and repair mechanisms.
- Long-term implications of neonatal oxygen exposure on DNA integrity and cancer risk.
Abstract:
In this review oxygenation and hyperoxic injury of newborn infants are described through molecular and genetic levels. Protection and repair mechanisms that may be important for a new understanding of oxidative stress in the newborn are discussed. The research summarized in this article represents a basis for the reduced oxygen supplementation and oxidative load of newborn babies, especially since the turn of the century. The mechanisms discussed may also contribute to an understanding of why hyperoxic resuscitation of the newborn may damage DNA and affect its repair, thus increasing the risk that it may be carcinogenic. Today, term babies should be resuscitated with air rather than 100% oxygen and very and extremely low birth weight infants in need of stabilization or resuscitation at birth should be administered initially 21-30% oxygen and the level should be titrated according to the response, preferably measured by pulse oximetry. In the postnatal period the oxygen saturation should be targeted low <95%; however, saturations between 85 and 89% seem to increase mortality. The optimal oxygen saturation target for these infants postnatally is still unknown.
Related Concept Videos
01:27Oxygen Transport in the Blood
01:29Oxygen Requirements and Growth Patterns
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:19Carbon Dioxide Transport in the Blood
Forms of CO2 Transport
1. Dissolved in plasma: A small percentage (7-10%) of CO2 is transported and dissolved directly in the plasma.
2. Carbaminohemoglobin: Just over 20% of CO2 is chemically bound to...
01:26Oxygenic Photosynthesis