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Longitudinal pilot study of oxygen saturation indices in healthy preterm infants

Longitudinal pilot study of oxygen saturation indices in healthy preterm infants
Longitudinal pilot study of oxygen saturation indices in healthy preterm infants

Background: This study aimed to determine patterns of nocturnal pulse oximetry indices in moderate to late preterm infants, and investigate the relationship between oxygen desaturations, the apnoea hypopnoea index, and both corrected gestational and postnatal age. Methods: 21 healthy infants born at 32 + 0 - 36 + 6 weeks gestation underwent serial nocturnal pulse oximetry studies and respiratory polygraphy studies until 40 weeks corrected gestational age (CGA). The main outcome measures were number of >3% oxygen desaturations/hour (ODI3), mean oxygen saturations, and number of apnoeas and hypopnoeas/hour. Results: Median ODI3 increased between weeks 1 and 3 from 49.9 to 85.4/hour (p = 0.017). Mean oxygen saturations reached a corresponding nadir of 96.0% in week 3, then increased to 96.8% in week 6 (p = 0.019). Mixed effects modelling demonstrated that ODI3 and mean saturations were influenced by postnatal age but not CGA (p < 0.05). Desaturations frequently occurred without an apnoea or hypopnoea. Conclusion: ODI3 rises then falls during the first 8 weeks of life in moderate to late preterm infants, independently of CGA. These interesting preliminary results highlight the importance of further serial data collection to generate age-specific normal ranges, and develop a better understanding of respiratory control in preterm infants. Impact: The frequency of >3% oxygen desaturations (ODI3) in healthy moderate to late preterm infants rises then falls after birth, peaking in postnatal week 3. There is a corresponding nadir in mean saturations.There were significant non-linear relationships between ODI3/mean saturations and postnatal age, but not corrected gestational age.The majority of brief oxygen desaturations occurred without an apnoea or hypopnoea.Normal ranges for oxygen saturation indices are not known in this population. These results demonstrate the need for further serial data collection to generate age-specific normal ranges and inform oxygen prescribing guidelines.

0031-3998
2062-2069
Falconer, Olivia
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Ivy, Savannah
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Le Carpentier, Dana
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Gavlak, Johanna
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Liddle, Natasha
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Senior, Emily
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Lowe, Paula
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Crowley, Philippa
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Young, Aneurin
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Johnson, Mark J.
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Beattie, Robert Mark
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Evans, Hazel J.
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Falconer, Olivia
bebcc28c-108c-47ba-bed8-047bfd6ccf4f
Ivy, Savannah
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Le Carpentier, Dana
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Gavlak, Johanna
15bfdfeb-374b-4108-86c8-ec0a1dade98e
Liddle, Natasha
a7af4da4-0c72-4d19-a758-75803ebfbb99
Senior, Emily
c2d43e4a-0301-4526-8657-1c0a6eb2e875
Lowe, Paula
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Crowley, Philippa
0d599abb-8c55-4914-8d97-c702fc12020e
Young, Aneurin
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Johnson, Mark J.
64135487-45a1-46a6-a34b-595143e3c9a6
Beattie, Robert Mark
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Evans, Hazel J.
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Falconer, Olivia, Ivy, Savannah, Le Carpentier, Dana, Gavlak, Johanna, Liddle, Natasha, Senior, Emily, Lowe, Paula, Crowley, Philippa, Young, Aneurin, Johnson, Mark J., Beattie, Robert Mark and Evans, Hazel J. (2023) Longitudinal pilot study of oxygen saturation indices in healthy preterm infants. Pediatric Research, 94 (6), 2062-2069. (doi:10.1038/s41390-023-02741-9).

Record type: Article

Abstract

Background: This study aimed to determine patterns of nocturnal pulse oximetry indices in moderate to late preterm infants, and investigate the relationship between oxygen desaturations, the apnoea hypopnoea index, and both corrected gestational and postnatal age. Methods: 21 healthy infants born at 32 + 0 - 36 + 6 weeks gestation underwent serial nocturnal pulse oximetry studies and respiratory polygraphy studies until 40 weeks corrected gestational age (CGA). The main outcome measures were number of >3% oxygen desaturations/hour (ODI3), mean oxygen saturations, and number of apnoeas and hypopnoeas/hour. Results: Median ODI3 increased between weeks 1 and 3 from 49.9 to 85.4/hour (p = 0.017). Mean oxygen saturations reached a corresponding nadir of 96.0% in week 3, then increased to 96.8% in week 6 (p = 0.019). Mixed effects modelling demonstrated that ODI3 and mean saturations were influenced by postnatal age but not CGA (p < 0.05). Desaturations frequently occurred without an apnoea or hypopnoea. Conclusion: ODI3 rises then falls during the first 8 weeks of life in moderate to late preterm infants, independently of CGA. These interesting preliminary results highlight the importance of further serial data collection to generate age-specific normal ranges, and develop a better understanding of respiratory control in preterm infants. Impact: The frequency of >3% oxygen desaturations (ODI3) in healthy moderate to late preterm infants rises then falls after birth, peaking in postnatal week 3. There is a corresponding nadir in mean saturations.There were significant non-linear relationships between ODI3/mean saturations and postnatal age, but not corrected gestational age.The majority of brief oxygen desaturations occurred without an apnoea or hypopnoea.Normal ranges for oxygen saturation indices are not known in this population. These results demonstrate the need for further serial data collection to generate age-specific normal ranges and inform oxygen prescribing guidelines.

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Accepted/In Press date: 9 July 2023
e-pub ahead of print date: 4 August 2023
Published date: December 2023
Additional Information: Funding Information: This work was supported by the National Institute for Health Research (NIHR) Clinical Research Network Wessex. MJ and AY are funded by the NIHR Southampton Biomedical research Centre. Publisher Copyright: © 2023, The Author(s).

Identifiers

Local EPrints ID: 483412
URI: http://eprints.soton.ac.uk/id/eprint/483412
ISSN: 0031-3998
PURE UUID: 764b301a-a7ff-43fb-b780-4fd8d707845c
ORCID for Aneurin Young: ORCID iD orcid.org/0000-0003-3549-3813
ORCID for Hazel J. Evans: ORCID iD orcid.org/0000-0001-9366-556X

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Date deposited: 30 Oct 2023 17:47
Last modified: 18 Mar 2024 04:17

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Contributors

Author: Olivia Falconer
Author: Savannah Ivy
Author: Dana Le Carpentier
Author: Johanna Gavlak
Author: Natasha Liddle
Author: Emily Senior
Author: Paula Lowe
Author: Philippa Crowley
Author: Aneurin Young ORCID iD
Author: Mark J. Johnson
Author: Robert Mark Beattie
Author: Hazel J. Evans ORCID iD

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