Trajectories of oxygen saturation within 6–72 hours after birth in neonates at moderate altitude:a prospective longitudinal cohort study  

作　　者：Qu‑Ming Zhao Hong‑Yan Chen Shi‑Xiu Li Wei‑Li Yan Xiao‑Jing Hu Guo‑Ying Huang 

机构地区：[1]Children’s Hospital of Fudan University,National Children’s Medical Center,399 Wan Yuan Road,Shanghai 201102,China [2]Shanghai Key Laboratory of Birth Defects,399 Wan Yuan Road,Shanghai 201102,China [3]Luchun County People’s Hospital,Luchun,China [4]Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases(2018RU002),Chinese Academy of Medical Sciences,Shanghai,China

出　　处：《World Journal of Pediatrics》2023年第9期894-901,共8页世界儿科杂志（英文版）

基　　金：supported by the National Key Research and Development Program of China(2021YFC2701004 and 2016YFC1000506);the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2019-I2M-5-002).

摘　　要：Trajectories of pulse oxygen saturation(SpO_(2))within the first few days after birth are important to inform the strategy for identifying asymptomatic hypoxemic disease but remain poorly substantiated at higher altitudes.Methods We performed a longitudinal cohort study with consecutive neonates at a local hospital in Luchun County,China,at an altitude of 1650 m between January and July 2020.We repeatedly measured the pre-and post-ductal SpO_(2)values at 6,12,18,24,36,48,and 72 hours after birth for neonates without oxygen supplements.All neonates underwent echocardiography and were followed up to 42 days after discharge.We included neonates without hypoxemic diseases to characterize the trajectories of SpO_(2)over time using a linear mixed model.We considered the 2.5th percentile as the reference value to define hypoxemic conditions.Results A total of 1061 neonates were enrolled.Twenty-five had non-cardiac hypoxemic diseases,with 84%(21/25)presenting with abnormal SpO_(2)within 24 hours.One had tetralogy of Fallot identified by echocardiography.Among the 1035 asymptomatic neonates,SpO_(2)values declined from 6 hours after birth,reached a nadir at 48 hours,and tended to level off thereafter,with identical patterns for both pre-and post-ductal SpO_(2).The reference percentile was 92%for both pre-and post-ductal SpO_(2)and was time independent.Conclusions A decline within 48 hours features SpO_(2)trajectories within the first 72 hours at moderate altitude.Our findings suggest that earlier screening may favorably achieve a benefit–risk balance in identifying asymptomatic hypoxemic diseases in this population.

关 键 词：Critical congenital heart disease Hypoxemic disease Pulse oximetry screening Pulse oxygen saturation 

分 类 号：O17[理学—数学]