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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
PubMed

Insights

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.
Abstract

Keywords:
SpO2 histogramsbronchopulmonary dysplasiahypoxemic eventspremature infantprematurity morbidities

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