Healthy Infants Have a Gradual Rise in Oxygen Saturation After Birth
Healthy Infants Have a Gradual Rise in Oxygen Saturation After Birth
Kamlin COF, O'Donnell CPF, Davis PG, and Morley CJ
J Pediatr. 2006;148:585-589
This study provides data on the usual oxygen saturations of healthy infants in the first few minutes after delivery. This study was conducted using a convenience sample of 205 Australian infants born in a single hospital.
Subjects were at least 31 weeks gestational age, and investigators attended the delivery to obtain pulse oximetry readings. Any infant who required supplemental oxygen after delivery was excluded from analyses.
Readings with a pulse oximeter (same model for all infants) were obtained from the right hand or wrist. The investigator then recorded saturations at every 60 seconds for the first 5 minutes and longer if needed until saturations reached > 90%.
Thirty of the 175 infants were later excluded from analyses, 18 for requiring resuscitation and 12 due to difficulties obtaining data/readings. At 1 minute, the median pulse oximetry value was 63%; at 2 minutes, 70%; at 3 minutes, 76%; at 4 minutes, 81%; and at 5 minutes, 90%.
On average, the infants did not reach pulse oximetry saturations of > 90% until 5.8 minutes. Neither maternal analgesia nor anesthesia was related to infant saturation. Infants born vaginally reached > 90% saturations more quickly than did infants born by cesarean (4.0 minutes vs 5.9 minutes, respectively; P < .01). Term newborns also reached > 90% saturations more quickly than did preterm newborns (4.7 vs 6.5 minutes; P < .001).
Gestational age and the presence of labor remained independent predictors of time to reach saturations of 90% or greater in multivariate analyses. The authors conclude that infants have a gradual rise in oxygen saturation after birth, and this rise in oxygen is slower among infants born by cesarean delivery and born preterm.
Observational data can be very helpful, and knowing what one might expect regarding oxygen saturations in the first few minutes after delivery is extremely valuable. However, more than just saturations go into the immediate assessment of a newborn, and the authors are very careful to note the limitations of pulse oximetry. So, if an infant is doing well by other means of assessment, then these data suggest that one shouldn't expect "perfect" saturations right away.
Abstract
Kamlin COF, O'Donnell CPF, Davis PG, and Morley CJ
J Pediatr. 2006;148:585-589
This study provides data on the usual oxygen saturations of healthy infants in the first few minutes after delivery. This study was conducted using a convenience sample of 205 Australian infants born in a single hospital.
Subjects were at least 31 weeks gestational age, and investigators attended the delivery to obtain pulse oximetry readings. Any infant who required supplemental oxygen after delivery was excluded from analyses.
Readings with a pulse oximeter (same model for all infants) were obtained from the right hand or wrist. The investigator then recorded saturations at every 60 seconds for the first 5 minutes and longer if needed until saturations reached > 90%.
Thirty of the 175 infants were later excluded from analyses, 18 for requiring resuscitation and 12 due to difficulties obtaining data/readings. At 1 minute, the median pulse oximetry value was 63%; at 2 minutes, 70%; at 3 minutes, 76%; at 4 minutes, 81%; and at 5 minutes, 90%.
On average, the infants did not reach pulse oximetry saturations of > 90% until 5.8 minutes. Neither maternal analgesia nor anesthesia was related to infant saturation. Infants born vaginally reached > 90% saturations more quickly than did infants born by cesarean (4.0 minutes vs 5.9 minutes, respectively; P < .01). Term newborns also reached > 90% saturations more quickly than did preterm newborns (4.7 vs 6.5 minutes; P < .001).
Gestational age and the presence of labor remained independent predictors of time to reach saturations of 90% or greater in multivariate analyses. The authors conclude that infants have a gradual rise in oxygen saturation after birth, and this rise in oxygen is slower among infants born by cesarean delivery and born preterm.
Observational data can be very helpful, and knowing what one might expect regarding oxygen saturations in the first few minutes after delivery is extremely valuable. However, more than just saturations go into the immediate assessment of a newborn, and the authors are very careful to note the limitations of pulse oximetry. So, if an infant is doing well by other means of assessment, then these data suggest that one shouldn't expect "perfect" saturations right away.
Abstract
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