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Growth Outcomes of Preterm Infants Exposed to Different Oxygen Saturation Target Ranges from Birth
Cristina T Navarrete1, Lisa A Wrage2, Waldemar A Carlo3
1University of Miami Miller School of Medicine, Miami, FL.
Insights
Lowering oxygen saturation targets for preterm infants on supplemental oxygen did not improve growth velocity or reduce growth failure. These findings suggest that current oxygen saturation guidelines for preterm infants do not significantly impact long-term growth outcomes.
Area of Science:
- Neonatal care
- Pediatric growth studies
- Respiratory support in preterm infants
Background:
- Preterm infants often require supplemental oxygen, necessitating careful monitoring of oxygen saturation levels.
- Establishing optimal oxygen saturation targets is crucial for balancing the risks of hypoxemia and hyperoxemia-related complications.
Purpose of the Study:
- To investigate the impact of lower versus higher oxygen saturation (SpO2) target ranges on growth velocity and growth failure in preterm infants receiving supplemental oxygen from birth.
- To determine if a lower SpO2 target (85%-89%) improves growth outcomes compared to a higher target (91%-95%) up to 18-22 months corrected age.
Main Methods:
- A subgroup of 810 preterm infants from a randomized trial were assigned to lower or higher SpO2 target ranges at birth.
- Anthropometric measurements were collected at multiple time points from birth to 18-22 months corrected age.
- Growth velocities were calculated, and growth failure was assessed using percentile data and regression analysis.
Main Results:
- Growth outcomes, including growth velocity and the incidence of growth failure at 36 weeks postmenstrual age and 18-22 months corrected age, were comparable between the lower and higher SpO2 target groups.
- No significant differences in anthropometric measures were observed between the groups over the study period.
Conclusions:
- Targeting SpO2 ranges between 85% and 95% from birth does not influence growth velocity or reduce growth failure in preterm infants.
- The findings suggest that current oxygen saturation management strategies within this range do not differentially affect long-term growth trajectories in this population.
Objective:
To test whether infants randomized to a lower oxygen saturation (peripheral capillary oxygen saturation [SpO2]) target range while on supplemental oxygen from birth will have better growth velocity from birth to 36 weeks postmenstrual age (PMA) and less growth failure at 36 weeks PMA and 18-22 months corrected age.
Study Design:
We evaluated a subgroup of 810 preterm infants from the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, randomized at birth to lower (85%-89%, n = 402, PMA 26 ± 1 weeks, birth weight 839 ± 186 g) or higher (91%-95%, n = 408, PMA 26 ± 1 weeks, birth weight 840 ± 191 g) SpO2 target ranges. Anthropometric measures were obtained at birth, postnatal days 7, 14, 21, and 28; then at 32 and 36 weeks PMA; and 18-22 months corrected age. Growth velocities were estimated with the exponential method and analyzed with linear mixed models. Poor growth outcome, defined as weight <10th percentile at 36 weeks PMA and 18-22 months corrected age, was compared across the 2 treatment groups by the use of robust Poisson regression.
Results:
Growth outcomes including growth at 36 weeks PMA and 18-22 months corrected age, as well as growth velocity were similar in the lower and higher SpO2 target groups.
Conclusion:
Targeting different oxygen saturation ranges between 85% and 95% from birth did not impact growth velocity or reduce growth failure in preterm infants.
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