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Published on: December 31, 2015
Neonatal oxygen saturations and blood pressure at school-age in children born extremely preterm: a cohort study
Marina S Oren1, Vlad Ianus1, Betty R Vohr2
1Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
Insights
Neonatal oxygen saturation targets did not affect blood pressure (BP) at school age. However, prolonged low oxygen levels (hypoxemia) in preterm infants were linked to higher systolic BP later in life.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Respiratory Physiology
Background:
- Extremely preterm infants (<28 weeks gestation) often experience fluctuating oxygen saturation levels.
- The long-term effects of neonatal oxygenation strategies on cardiovascular health are not fully understood.
- Establishing optimal oxygen saturation targets is crucial for improving outcomes in extremely preterm infants.
Purpose of the Study:
- To investigate the association between neonatal oxygen saturation and blood pressure (BP) at 6-7 years of age.
- To determine if different oxygen saturation targets in extremely preterm infants influence later BP.
- To examine the impact of neonatal hypoxemia on school-age blood pressure.
Main Methods:
- A cohort of infants born extremely preterm (<28 weeks gestation) was assigned to higher or lower oxygen saturation targets.
- Neonatal oxygen saturation was monitored continuously using pulse oximetry.
- Blood pressure was measured at 6-7 years of age in survivors and compared based on assigned oxygen groups, achieved saturations, and duration of hypoxemia.
Main Results:
- No significant differences in systolic or diastolic blood pressure were observed between the higher and lower oxygen saturation target groups.
- Median achieved weekly oxygen saturation levels during the neonatal period were not associated with blood pressure at school age.
- A longer duration of hypoxemia (oxygen saturation <80%) during the first postnatal week was significantly associated with higher systolic blood pressure at 6-7 years of age.
Conclusions:
- Neither the assigned oxygen saturation target nor the median achieved oxygen saturation in the neonatal period predicted blood pressure at school age.
- Increased exposure to hypoxemia in the first week of life is a risk factor for elevated systolic blood pressure in extremely preterm survivors at 6-7 years of age.
- Minimizing hypoxemic episodes in extremely preterm infants may be important for long-term cardiovascular health.
Objective:
To explore the relationship between neonatal oxygen saturation and BP at age 6-7 years in a cohort of infants born extremely preterm.
Study Design:
Infants <28 weeks gestation were assigned to a higher or lower oxygen saturation target. Oximeter data were monitored throughout the neonatal period. A subset of survivors was seen at age 6. BP was measured and compared by group assignment, achieved saturations, and time spent in hypoxemia (saturations <80%).
Results:
There was no difference in systolic or diastolic BP between assigned groups. Median achieved weekly oxygen saturation was not associated with BP. Longer duration of hypoxemia during the first week of age was associated with higher systolic BP.
Conclusions:
Neither target nor actual median oxygen saturations in this study was associated with BP at school age. Increased duration of hypoxemia in the first postnatal week was associated with higher systolic BP at 6-7 years of age.
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