Growth Outcomes of Preterm Infants Exposed to Different Oxygen Saturation Target Ranges from Birth

• Type of Material: Article
• Authors: Cristina T. Navarrete, University of Miami; Lisa A. Wrage, RTI International; Waldemar A. Carlo, University of Alabama Birmingham; Michele C. Walsh, Case Western Reserve University; Wade Rich, University of California San Diego; Marie G. Gantz, RTI International; Abhik Das, RTI International; Kurt Schibler, University of Cincinnati; Nancy S. Newman, University of California San Diego; Anthony Piazza, Emory University; Brenda B. Poindexter, Indiana University School of Medicine; Seetha Shankaran, Wayne State University; Pablo J. Sanchez, University of Texas Southwestern Medical Center; Brenda H. Morris, University of Texas Medical School at Houston; Ivan D. Frantz III, Floating Hospital for Children at Tufts Medical Center; Krisa P. Van Meurs, Stanford University; C. Michael Cotten, Duke University; Richard A. Ehrenkranz, Yale University; Edward F. Bell, University of Iowa; Kristi L. Watterberg, University of New Mexico; Rosemary D. Higgins, Eunice Kennedy Shriver National Institute of Child Health and Human Development; Shahnaz Duara, University of Miami
• Language: English
• Date: 2016-06-22
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jpeds.2016.05.070
• Title of Journal or Parent Work: Journal of Pediatrics
• ISSN: 0022-3476
• Volume: 176
• Start Page: 62
• End Page: +
• Grant/Funding Information: The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute provided grant support for the Neonatal Research Network’s SUPPORT Trial.; Additional funding information is available at www.jpeds.com (Appendix).
• Keywords: RETINOPATHY; NEONATAL RESEARCH NETWORK; GESTATION; HYPOXEMIA; BRONCHOPULMONARY DYSPLASIA; WEIGHT INFANTS; CONTROLLED-TRIAL; Life Sciences & Biomedicine; PULSE OXIMETRY; Pediatrics; INTRAUTERINE GROWTH; Science & Technology; INTENSIVE-CARE-UNIT
• Research Categories: Environmental Sciences; Health Sciences, General

Abstract

Objective: To test whether infants randomized to a lower oxygen saturation (peripheral capillary oxygen saturation [SpO 2 ]) target range while on supplemental oxygen from birth will have better growth velocity from birth to 36 weeks postmenstrual age (PMA) and less growth failure at 36 weeks PMA and 18-22 months corrected age. Study design: We evaluated a subgroup of 810 preterm infants from the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, randomized at birth to lower (85%-89%, n = 402, PMA 26 ± 1 weeks, birth weight 839 ± 186 g) or higher (91%-95%, n = 408, PMA 26 ± 1 weeks, birth weight 840 ± 191 g) SpO 2 target ranges. Anthropometric measures were obtained at birth, postnatal days 7, 14, 21, and 28; then at 32 and 36 weeks PMA; and 18-22 months corrected age. Growth velocities were estimated with the exponential method and analyzed with linear mixed models. Poor growth outcome, defined as weight < 10th percentile at 36 weeks PMA and 18-22 months corrected age, was compared across the 2 treatment groups by the use of robust Poisson regression. Results: Growth outcomes including growth at 36 weeks PMA and 18-22 months corrected age, as well as growth velocity were similar in the lower and higher SpO 2 target groups. Conclusion: Targeting different oxygen saturation ranges between 85% and 95% from birth did not impact growth velocity or reduce growth failure in preterm infants.