J Med Assoc Thai 2015; 98 (7):656

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Time Duration of Oxygen Adaptation Immediately after Birth; Monitoring by Pulse Oximeter in Perinatal Period of the Infants at Charoenkrung Pracharak Hospital
Suwattanaphim S Mail, Yodavuhd S , Puangsa-art S

Background: Oxygen Saturation is one of the important data to determine patient status and worldwide applied in several situations. Evaluation about status of immediate perinatal period of the infant usually uses clinical assessment, Apgar scoring, which had been used for a long time without other scientific measurement. Pulse oximeter, the non-invasive measurement of oxygen saturation, may play role for oxygen saturation evaluation in newborn that immediately change from intra to extra uterine environment.

Objective: Monitoring the time duration that immediately born infants by normal labor or Cesarean section modes, used to archived target oxygen saturation (SpO2) and looking for the other factors that influence oxygen saturation adaptation.

Material and Method: The data of the 553 infants born in Charoenkrung Pracharak Hospital, Bangkok, Thailand between October 2012 and April 2013 were collected. The 204 healthy newborns that met all criteria were studied. All infants were recorded pulse oximeter from the second to the tenth minute after birth. They were grouped by several factors such as maternal gravidity, gestational age, mode of delivery, Apgar score, birth weight, and sex. Time interval to achieve target oxygen saturation (SpO2 ≥90%) was collected for analysis.

Results: The oxygen saturation of infants immediately after birth showed an increase. Median time interval was 6.5 (2-10) minutes for 90% saturation and 7 (2-10) minutes for 95% saturation, respectively. Only mode of delivery showed statistical significant time difference (p<0.001). A Cox proportional hazards analysis of the Kaplan-Meier curves demonstrated that infants born by cesarean delivery took significantly longer time to reach a stable SpO2 ≥90% than infants born by vaginal delivery (95% CI = 1.28 to 2.74; p<0.01).

Conclusion: A newly born infant has to take 6.5 minutes (2-10) after birth to adjust their oxygen saturation to reach normal higher level of extra uterine life, median SpO2 of 90%. Furthermore, mode of delivery makes a significant difference of oxygen saturation status; the cesarean route takes significantly longer time than the vaginal route to achieve SpO2 ≥90%.

Keywords: Oxygen saturation, Vaginal delivery, Cesarean delivery, Infants

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