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Oxygenation Instability and Short-Term Morbidities Among Very-Low-Birthweight Premature Infants
Viktoria Leikin Zach1,2, Arieh Riskin1,3, Irina Raizberg2
1Technion-Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.
Acta Paediatrica (Oslo, Norway : 1992)
|May 5, 2025
Summary
Oxygenation instability in very-low-birthweight infants is common. Early instability in the first week of life predicts higher risk of bronchopulmonary dysplasia or death.
Area of Science:
- Neonatology
- Pediatric Respiratory Medicine
- Critical Care Medicine
Background:
- Oxygenation instability is a frequent issue in very-low-birthweight (VLBW) infants.
- This instability is linked to significant morbidities associated with prematurity.
Purpose of the Study:
- To investigate the association between oxygenation instability in VLBW infants during the first week of life and short-term neonatal morbidities.
- To analyze oxygenation patterns using SpO2 histograms.
Main Methods:
- Included VLBW infants requiring respiratory support.
- Recorded 24-hour SpO2 histograms daily.
- Classified histograms into stable/unstable categories using a distribution-based system.
Main Results:
- 77 VLBW infants (mean gestational age 28.5 weeks) were studied.
- 38% of infants experienced oxygenation instability, with 52% entering this phase within the first week.
- Instability during the first week significantly increased the risk of bronchopulmonary dysplasia (BPD)/death (aOR 32.4).
Conclusions:
- VLBW infants exhibit a specific oxygenation instability pattern.
- Early entry into an unstable phase within the first week of life is a predictor for BPD/death.
- Hypoxemia burden in the first week correlates with BPD/death; iatrogenic hyperoxemia does not.
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