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Comparative Study
. 2011 Sep;159(3):377-383.e1.
doi: 10.1016/j.jpeds.2011.02.011. Epub 2011 Apr 9.

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

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Free PMC article
Comparative Study

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

Carl E Hunt et al. J Pediatr. .
Free PMC article

Abstract

Objective: To report longitudinal home recordings of hemoglobin O(2) saturation by pulse oximetry (Spo(2)) 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 Spo(2) 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% Spo(2) was initially significantly greater in the preterm than the term group and declined with age at a similar rate in both groups. The 75(th) to 95(th) percentiles for seconds/hour of Spo(2) <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.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Summary of the selection process for reaching the final number of infants enrolled in the preterm and term infant groups. The healthy term cohort includes 67 infants previously reported. Preterm: <1750g and ≤34 weeks PMAinweeks, at birth.
Figure 2
Figure 2
Assessment of 3-minute nonevent epoch. This epoch is from a healthy term infant at 63 weeks PMA. Step 1: Determine baseline Spo2; the two cursor lines mark the beginning and end of the segment meeting criteria for baseline Spo2. Step 2: Identify acute decreases in Spo2: there is one acute decrease in this epoch. Each decrease is then scored for duration <90% and <80%, lowest Spo2, and the longest respiratory pause associated with a decrease. Step 3: Identify all respiratory pauses >4 seconds; there is one respiratory pause >4 seconds in this epoch. The total number of pauses >4 seconds is counted and their duration recorded with the scoring tool. Step 4: Identify periodic breathing and the duration of each episode. There is only one apparent episode in this epoch. Step 5: Identify sleep position for baseline Spo2 and acute decreases in Spo2.
Figure 3
Figure 3
Baseline SpO2 percentiles. A, Preterm cohort of 103 infants at 36 to 59 weeks PMA. B, Term cohort of 99 infants at 43 to 65 weeks PMA.
Figure 4
Figure 4
Frequency of intermittent hypoxia (Spo2 <90%) in preterm and term cohorts. A, Percent of infants in preterm and term cohorts with ≥1 episode of intermittent hypoxemia. B, Number of seconds with Spo2 <90% during intermittent hypoxemia, expressed per hour of recording time for each week PMA. A, SD bars, and B, SE bars have been included where the bars for the groups do not overlap. IH, intermittent hypoxia.

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