Treating very premature infants with high oxygen levels to improve their ability to breathe appears to boost their chances of surviving into toddlerhood, a new U.S. National Institutes of Health study found.
The report is a follow-up to a 2010 study that found higher immediate survival rates among babies who were born between 24 and 27 weeks' gestation who were given high oxygen treatment. That study found that when given highly saturated oxygen (from 91% to 95%), premature infants fared better than those given relatively low saturated oxygen (from 85% to 89%).
But concern about long-term survival, as well as a related risk for severe vision impairment, led the research team to continue tracking the infants until they reached the age of 18 months to 22 months after their original due date (the date they would have been born if carried to full term, which is generally considered about 40 weeks' gestation).
Study senior author Dr. Rosemary Higgins, of the pregnancy and perinatology branch of the U.S. National Institute of Child Health and Human Development, said in an institute news release that "higher oxygen targets improve survival and don't appear to threaten survivors' vision in the longer term."
Higgins and her colleagues report the results in the Dec. issue of the New England Journal of Medicine.
High oxygen treatment = higher survival rate
To assess the relative benefits of high or low oxygen treatment, the authors focused on toddler survival and developmental status among 1,300 preterm infants who had been born sometime between 2005 and 2009.
The investigators found that 60% of all of the preterm infants (regardless of treatment type) showed no signs of either physical or mental impairment as toddlers.
What's more, as a whole, all of the infants seemed to fare comparably well, regardless of treatment approach, when the investigators pooled survival rates and mental and motor development scores.
However, when Higgins and her associates looked more closely at the findings, they noted that high oxygen treatment did specifically translate into higher survival rates.
Importantly, the authors further noted that premature infants who had been offered an adult sleep apnoea treatment called "continuous positive airway pressure" (CPAP) fared as well as those who were given a more standard treatment involving a ventilator and lung coating substance (known as surfactant treatment).
"CPAP for infants has been available since the 1970s," explained Higgins. "This is the first study to compare surfactant treatment to CPAP in a large group of infants, and these results reassure us that CPAP is as good a choice in the first hour of life as traditional methods for very preterm babies who need help breathing," she said.
"But although these findings can give delivery room practitioners confidence in a suitable approach, they can't help predict how these children will grow or how well they'll do in school," she added. "Our group will continue to monitor the health of a subset of these children through childhood, to determine if there are any major differences between the groups."
(Alan Mozes, HealthDayNews, December 2012)
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