title: Reevaluating reference ranges of oxygen saturation for healthy full-term neonates using pulse oximetry.
abstract: BACKGROUND
  We compared our clinical experience with currently available reference oxygen saturation level (SpO(2)) values from the American Academy of Pediatrics/American Heart Association (AAP/AHA) neonatal resuscitation program guidelines.
  
  
  METHODS
  We enrolled 145 healthy full-term neonates; infants showing respiratory distress and those with serious congenital anomalies were excluded. SpO(2) values at every 1 minute until 10 minutes after birth were measured and recorded. Infants were classified into the cesarean section (CS) and normal spontaneous delivery (NSD) groups for evaluating differences. The 10(th) percentiles of SpO(2) at each minute were used as the lower limits of normal oxygen saturation, and these were compared with the lowest target values recommended in the AAP/AHA guidelines.
  
  
  RESULTS
  Overall, 130 vigorous full-term neonates (median gestational age: 38 5/7 weeks; body weight at birth: 2405-3960 g) were analyzed. The median SpO(2) were 67% and 89% at the 1(st) and 4(th) minute, respectively. On average, SpO(2) values reached >90% at the 5(th) minute. No statistical differences were noted in the SpO(2) values between the CS and NSD groups after 5 minutes; however, a trend of higher SpO(2) was observed in the NSD group. We noted a gradually increasing trend for SpO(2) values over time, similar to that noted in the AAP/AHA guidelines. However, SpO(2) values at the 10(th) percentiles of each minute within the first 5 minutes in our study were equal to or significantly lower than those in the AAP/AHA guidelines; moreover, at the 10(th) minute, SpO(2) values at the 10(th) percentiles were significantly higher than those in the guidelines.
  
  
  CONCLUSIONS
  The delivery modes did not affect the SpO(2) values of full-term healthy neonates. Discrepancies in SpO(2) changes in full-term neonates not requiring resuscitation between this study and the AAP/AHA guidelines were significant. SpO(2) ranges for each time point within the first 10 minutes after birth should therefore be reevaluated locally.
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan; Graduate Institute of Basic Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Ying-Chun
authors.initials: YC
authors.lastname: Lu
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Kwei-Shuai
authors.initials: KS
authors.lastname: Hwang
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Hua
authors.affiliation: Department of Pediatrics, Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: Yeong-Seng
authors.initials: YS
authors.lastname: Yuh
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yu-Lung
authors.initials: YL
authors.lastname: Chiu
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wan-Fu
authors.initials: WF
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Chou
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shao-Wei
authors.initials: SW
authors.lastname: Huang
authors.affiliation: School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Yih-Jing
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: fanhuengchuen@yahoo.com.tw.
authors.forename: Hueng-Chuen
authors.initials: HC
authors.lastname: Fan
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D014481:United States
chemical_list: D010100:Oxygen
keywords: arterial oxygen saturation; full-term neonates; pulse oximeter