Elsevier

The Journal of Pediatrics

Volume 159, Issue 3, September 2011, Pages 377-383.e1
The Journal of Pediatrics

Original Article
Longitudinal Assessment of Hemoglobin Oxygen Saturation in Preterm and Term Infants in the First Six Months of Life

https://doi.org/10.1016/j.jpeds.2011.02.011Get rights and content

Objective

To report longitudinal home recordings of hemoglobin O2 saturation by pulse oximetry (Spo2) during unperturbed sleep in preterm and term infants.

Study design

We recorded continuous pulse oximetry during the first 3 minutes of each hour of monitor use (nonevent epochs) for 103 preterm infants born at <1750 g and ≤34 weeks postmenstrual age (PMA), and 99 healthy term infants.

Results

Median baseline Spo2 was approximately 98% for both the preterm and term groups. Episodes of intermittent hypoxemia occurred in 74% of preterm and 62% of term infants. Among infants with intermittent hypoxemia, the number of seconds/hour of monitoring <90% Spo2 was initially significantly greater in the preterm than the term group and declined with age at a similar rate in both groups. The 75th to 95th percentiles for seconds/hour of Spo2 <90% in preterm infants were highest at 36 weeks PMA and progressively decreased until 44 weeks PMA, after which time they did not differ from term infants.

Conclusions

Clinically inapparent intermittent hypoxemia occurs in epochs unperturbed by and temporally unrelated to apnea or bradycardia events, especially in preterm infants at 36 to 44 weeks PMA.

Section snippets

Methods

Detailed methods for the CHIME study and for the recording and analysis of Spo2 have previously been reported.2, 3 Written informed consent was obtained for each infant, and the study was approved by the institutional review board at each of the five clinical sites.

The CHIME study included preterm infants born at <1750 g and <35 weeks postmenstrual age (PMA) and healthy term infants. Because of the data processing costs associated with scoring physiological data for this analysis, a priori

Results

The maternal and infant characteristics of the preterm and term infants included in this report are summarized in the Table. To assess the extent that infants included in the analyses differed from those not included, we also compared the included infants with (1) those excluded because of insufficient monitor use and (2) those meeting the monitor use criterion but not selected for inclusion. Consistent with previously published data, infants included in this study had mothers who were older,

Discussion

These data provide insight into expected Spo2 values over time in apparently healthy preterm and term infants during the first 6 months of life studied in the home with noninvasive monitoring. Baseline values were similar for preterm and term infants, with median values of around 98%, although there were changes in median baseline values over time. Acute decreases in Spo2 (intermittent hypoxia) were common in both preterm and term infants and strongly related to PMA. In preterm infants, the

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  • Cited by (0)

    Supported by NIH HD 29067, 29071, 28971, 29073, 29060, 20056, and 34625.

    The authors declare no conflicts of interest.

    List of members of the CHIME Study Group is available at www.jpeds.com (Appendix).

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