A recent study by the University of Sydney suggests that administering oxygen at a concentration of 90 to 100 percent immediately after birth could significantly reduce the mortality risk for very premature babies who require breathing assistance.
The research, published in JAMA Pediatrics, examined data from over a thousand premature infants. These babies, born before 32 weeks of gestation, were given varying concentrations of oxygen—low (~30 percent), intermediate (~50-65 percent), and high (~90 percent). The study found that starting resuscitation with high concentrations of oxygen (90 percent or greater) could double their chances of survival compared to using lower levels (21 to 30 percent).
Premature infants often struggle to breathe due to underdeveloped lungs. To support their breathing, doctors provide extra oxygen through masks or breathing tubes. The study’s findings indicate that higher initial oxygen levels might help these infants start breathing independently. However, more research is needed to understand why this is effective.
The research team emphasized the importance of adjusting oxygen levels quickly to avoid hyperoxia, which is when too much oxygen causes organ damage. They highlighted that the first 10 minutes after birth are critical, requiring careful monitoring and adjustment of oxygen levels.
If further studies confirm these findings, they could challenge current international guidelines, which recommend using room air (21 percent oxygen) or slightly higher levels for preterm babies. These guidelines were influenced by past research primarily focused on full-term infants, who typically have fully developed lungs.
Globally, over 13 million babies are born prematurely each year, with nearly 1 million dying shortly after birth. This study highlights the need for tailored approaches in treating premature infants.
Dr. James Sotiropoulos, the lead author, stressed the importance of proper initial treatment for very premature infants to ensure healthy lives. He noted that while these findings are promising, larger studies are necessary to confirm them.
Historically, 100 percent oxygen was used to resuscitate all newborns. However, concerns about hyperoxia led to changes in 2010, recommending lower oxygen levels for preterm infants. This study suggests that the needs of preterm infants may differ significantly from those of full-term infants.
Dr. Anna Lene Seidler from the NHMRC Clinical Trials Centre added that ongoing research aims to determine the best treatment for newborns. She acknowledged the collaborative efforts of international researchers in this field, contributing diverse expertise and experience to this important work.
