Study of SPO2 Trends in Healthy Term and Preterm Neonates During First 10 Minutes of Life

Abstract

INTRODUCTION: Oxygen is essential for the successful progression of physiological activities of human beings. The transition from intrauterine to extra uterine life is generally smooth; however a small fraction of neonates (5-10%) needs some assistance in breathing and a relatively much smaller (1%) requires extensive resuscitation1,2. The indications and timing of supplemental oxygen therapy to assist the newborn in this transition has been a matter of debate3-8. It has been shown in literature that in healthy term neonates, the SpO2 of 90% or above is achieved within 10 minutes of birth9. The preterm neonates have different SpO2 trends as compared to healthy term neonates during the initial few minutes of birth as the fetus is accustomed to relatively low oxygen exposure and the mechanisms for managing high oxygen levels are not yet completely developed10. Although there is plenty of data on this issue arising from western literature, there is lack of such studies in Indian environment, hence, the present study was planned with an aim to study the trends in neonatal SpO2 levels during the first 10 minutes as a comparative study between preterm and healthy term neonates and also to evaluate the impact of mode of delivery. METHODS: It is a Prospective observational study carried out in the Department of Paediatrics SBKS,MI&RC. All healthy term and late preterm (completed 34 weeks to 36wks 6days) newborns were enrolled in the study where their SpO2 was monitored for the first ten minutes of their birth with the help of pulse oxymeter. RESULTS: In present study, in an overall sample of 145 neonates (93 term and 52 preterm), the normative range for SpO2 in neonates was 61.38 to 62.46%, 66.63 to 67.73%, 71.66 to 72.71% 77.06 to 78.11%, 82.16 to 83.12%, 61.38 to 62.46%, and 90.82 to 91.13% at 1 min, 2min, 3 min, 4 min, 5 min, 7 min and 10 min of life respectively. The normative range of SpO2 in preterm neonates was 58.77-59.35%, 64.17-64.63%, 69.13- 69.91%, 74.80-75.50%, 80.16-81.03%, 84.15-84.96% and 88.23-88.89% at 1 min, 2min, 3 min, 4 min, 5 min, 7 min and 10 min of life respectively. CONCLUSION: In present study, mean SpO2 levels were significantly higher in full term neonates as compared to preterm neonates throughout the evaluation period.