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August 11, 2015

Hypoxemic Episodes and Adverse Neurodevelopmental Outcome in Extremely Preterm Infants

Author Affiliations
  • 1Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
  • 2Research Office, Royal Women’s Hospital, Parkville, Victoria, Australia
  • 3Clinical Sciences, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
JAMA. 2015;314(6):568-569. doi:10.1001/jama.2015.9136

Extremely preterm infants (<28 weeks’ gestational age) have higher rates of adverse neurodevelopmental outcomes in early childhood than children born at term.1 In this issue of JAMA, Poets et al2 present a post hoc analysis of data from 1019 extremely preterm infants in the multicenter Canadian Oxygen Trial (COT),3 analyzing the relationships between episodes of hypoxemia (pulse oximetry oxygen saturation levels <80%) and bradycardia (pulse rate <80/min) measured every 10 seconds for a mean of 68 days and the primary outcome of death or disability (cognitive or language delay, motor impairment, deafness, or blindness) at 18 months’ corrected age. Secondary outcomes included cognitive or language delay, motor impairment, and severe retinopathy of prematurity. The investigators found that episodes of hypoxemia were more important than episodes of bradycardia. Hypoxemic episodes were associated with death or disability in 56.5% in the highest decile of exposure vs 36.9% in the lowest decile (modeled relative risk, 1.53; 95% CI, 1.21-1.94).