To the Editor We read the Research Letter “Association of Oxygen Target and Growth Status With Increased Mortality in Small for Gestational Age Infants: Further Analysis of the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial”1 with great interest. Walsh et al1 have made an astute observation that increased mortality in infants randomized to the low oxygen saturation by pulse oximeter (SpO2) target group in the Surfactant, Positive Pressure and Pulse Oximetry Randomized Trial (SUPPORT)2 was predominantly owing to high rate of death before discharge among small for gestational age (SGA) infants. The leading causes of mortality in preterm SGA infants were respiratory distress syndrome and bronchopulmonary dysplasia (BPD), which may have been accompanied by pulmonary hypertension (PH).
Lakshminrusimha S, Manja V, Steinhorn RH. Interaction of Target Oxygen Saturation, Bronchopulmonary Dysplasia, and Pulmonary Hypertension in Small for Gestational Age Preterm Neonates. JAMA Pediatr. 2016;170(8):807-808. doi:10.1001/jamapediatrics.2016.1001