Revised threshold values for neonatal oxygen saturation at mild and moderate altitudes

Area of Science:

• Neonatal Medicine
• Environmental Physiology
• Pediatric Pulmonology

Background:

• Neonatal oxygen saturation (SpO2) reference values are crucial for early disease detection.
• Altitude significantly impacts SpO2 levels, necessitating altitude-specific reference ranges.
• Existing SpO2 cut-offs may not be optimal for neonates born at varying altitudes.

Purpose of the Study:

• To determine reference values for neonatal SpO2 at mild and moderate altitudes.
• To establish altitude-specific screening cut-offs for neonatal SpO2.
• To provide updated guidance for pediatricians in high-altitude regions.

Main Methods:

• A large cohort of 41,097 asymptomatic neonates from 35 hospitals in Yunnan, China, was studied.
• Neonates were categorized into low (0-500m), mild (500-1500m), and moderate (1500-2500m) altitude groups.
• Pre- and post-ductal SpO2 were measured at 24 hours and before discharge.

Main Results:

• Mean SpO2 decreased by 1.54% for every 1000m increase in altitude.
• Mean pre-ductal SpO2 was 97.9% (low), 96.4% (mild), and 95.5% (moderate) altitude.
• New SpO2 cut-offs recommended: ≤93% (mild), ≤92% (moderate), no adjustment (low).

Conclusions:

• Revised SpO2 cut-off values are recommended for neonates at mild and moderate altitudes.
• These updated values will aid pediatricians in screening for severe congenital heart or lung diseases.
• The study provides essential data for neonatal care in high-altitude environments.