Oxygen saturation in healthy infants immediately after birth

Objective

Because the optimal concentration of oxygen (FiO₂) required for stabilization of the newly born infant has not been established, the FiO₂ is commonly adjusted according to the infant’s oxygen saturation (SpO₂). We aimed to determine the range of pre-ductal SpO₂ in the first minutes of life in healthy newborn infants.

Study design

We applied an oximetry sensor to the infant’s right palm or wrist of term and preterm deliveries immediately after birth. Infants who received any resuscitation or supplemental oxygen were excluded. SpO₂ was recorded at 60 second intervals for at least 5 minutes and until the SpO₂ was >90%.

Results

A total of 205 deliveries were monitored; 30 infants were excluded from the study. SpO₂ readings were obtained within 60 seconds of age from 92 of 175 infants (53%). The median (interquartile range) SpO₂ at 1 minute was 63% (53%-68%). There was a gradual rise in SpO₂ with time, with a median SpO₂ at 5 minutes of 90% (79%-91%).

Conclusion

Many newborns have an SpO₂ <90% during the first 5 minutes of life. This should be considered when choosing SpO₂ targets for infants treated with supplemental oxygen in the delivery room.

Abbreviations:  FiO₂, Concentration of oxygen , IQR, Interquartile ranges , nCPAP, Nasal continuous positive pressure , SpO₂, Oxygen saturation