Oxygen saturation in healthy-term neonates at high altitude: A multisite prospective study

Objectives: To determine oxygen saturation (SpO₂) values and their variability in healthy-term neonates at high altitude.

Methods: In a prospective multisite, non-randomized blinded study, we performed SpO₂ measurements in healthy neonates admitted to postnatal wards and followed up in Public Health Nurse Clinics (PHNC) in Calgary, Alberta, Canada. We recruited healthy-term neonates (≥37 weeks) between 6 and 24 h of age. Neonates underwent simultaneous pre- and post-ductal SpO₂ recordings every 12 to 24 h until hospital discharge and again in the PHNC within a few days after discharge. Neonates were followed for 8 weeks to ascertain their health status.

Results: We included data for 252 neonates in hospital and 105 neonates presenting to the PHNC for follow-up. In hospital, the mean pre- and post-ductal SpO₂ were 94.3% and 96.0%, respectively. In the PHNC, mean pre- and post-ductal SpO₂ were 94.4% and 95.6%, respectively. Desaturation episodes occurred frequently at a median rate of once every 5 minutes. The median duration of pre-ductal desaturation episodes was longer in hospital than in the PHNC for all SpO₂ thresholds (P < 0.05).

Conclusion: SpO₂ levels in healthy-term neonates at high altitude are approximately 94% and remained stable over the first few days after birth. Desaturation episodes are common in the immediate neonatal period, but their duration decreases over time, and they are not associated with clinical deterioration.Clinic trials.org (NCT02095041).