Lower oxygen saturation targets in preterm infants are not associated with increased rates of pulmonary hypertension

Article type: Research Article

Authors: Niccum, M.^{a; g} | Spyropoulos, F.^{b; g} | Levin, J.C.^{c; d; g} | Petty, C.R.^e | Mullen, M.P.^{f; g} | Christou, H.^{b; g; *}

Affiliations: [a] Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA | [b] Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, USA | [c] Department of Pediatrics, Division of Newborn Medicine, Boston, MA, USA | [d] Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, USA | [e] Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA | [f] Department of Cardiology, Boston Children’s Hospital, Department of Pediatrics, Boston, MA, USA | [g] Harvard Medical School, Boston, MA, USA

Correspondence: [*] Address for correspondence: Helen Christou, MD, Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, 75 Francis Street, Thorn 1005, Boston, MA 02115, USA. E-mail: hchristou@bwh.harvard.edu.

Abstract: BACKGROUND:The optimal oxygen saturation target in preterm infants is not known. In this study, we aimed to assess the effect of lower oxygen saturation targets on the rate of bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and pulmonary hypertension (PH) in preterm infants. METHODS:Retrospective cohort study comparing BPD, ROP, and PH incidence among two cohorts of infants born at≤32 weeks gestation with different oxygen saturation targets at≥34 weeks post-menstrual age (PMA): cohort 1, 94–98% (n = 126); cohort 2, 92–97% (n = 121). Groups compared by Chi-square test, t-test, and multivariable logistic regression. RESULTS:When comparing cohort 1 (average gestational age 29.8 weeks, average birth weight 1271g) with cohort 2 (average gestational age 29.6 weeks, average birth weight 1299g), there was no difference in rate of BPD (24% vs. 19%, p = 0.38), ROP (4% vs. 3%, p = 0.49), or PH (2% vs. 4%, p = 0.44). CONCLUSION:An oxygen saturation target of 92–97% at≥34 weeks PMA was not associated with a higher rate of PH or lower rate of BPD or ROP when compared with a higher target of 94–98%.

Keywords: Bronchopulmonary dysplasia, pulmonary hypertension, saturation parameters

DOI: 10.3233/NPM-200637

Journal: Journal of Neonatal-Perinatal Medicine, vol. 14, no. 4, pp. 519-526, 2021