Association between 5-minute oxygen saturation and neonatal death and intraventricular hemorrhage among extremely preterm infants

OBJECTIVE: To assess the relationship between 5-min oxygen saturation (SpO2) and outcomes in extremely preterm infants. STUDY DESIGN: This cohort study included infants ≤28 weeks' gestation across nine hospitals from 2020 to 2022. Death and / or severe intraventricular hemorrhage (IVH) were compared between infants with 5-min SpO2 < 80% and 80-100% using Poisson regression models. Receiver Operating Characteristic (ROC) curve and optimal breakpoint analysis were used to estimate the optimal breakpoint of 5-min SpO2 in relation to outcomes. RESULT: Of 390 infants, 184 (47.2%) had 5-min SpO2 < 80%. A 5-min SpO2 < 80% was independently associated with increased risks of death and / or severe IVH, early death, and severe IVH. ROC analysis of 5-min SpO2 identified optimal breakpoint at 81-85%, above which no additional benefit in outcomes was observed. CONCLUSION: Our findings support the current recommendation of 5-min SpO2 target of ≥80% for extremely preterm infants.