Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral...

Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO₂)<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO₂), compared to infants reaching the target. Methods: Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO₂ and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO₂ ≥ 80% ("≥80% group") and those with a 5-min SpO₂ < 80% ("<80% group"). Groups were compared regarding rcStO₂, SpO₂, and HR. Furthermore, we analyzed whether a 5-min SpO₂ < 80% was associated with a rcStO₂ below the 10th percentile at the same time point. Results: 146 neonates were included, with 68 (47%) in the "≥80% group" and 78 (53%) in the "<80% group." Neonates in the " <80% group" had a significantly lower rcStO₂ (p < 0.001). Furthermore, 80.3% of neonates in the " <80% group" and 23.4% in the "≥80% group" had rcStO₂ values below the 10th percentile at 5 min (p < 0.001). HR was significantly lower at minute 3 and 4 in the " <80% group" (p < 0.002). Conclusion: Preterm infants needing respiratory support, who do not reach the SpO₂ target of 80% at 5 min after birth, show significantly diminished rcStO₂ values compared to neonates reaching the target.