There is a raised risk of disability or death as a toddler for children who experienced prolonged low blood oxygen as a new baby, researchers reported last night.
Hypoxaemia, or abnormally low levels of oxygen in the blood leading to shortness of breath, is very common during the first three months of life, among extremely preterm infants (born at less than 28 weeks’ gestation).
An analysis was carried out by Dr Christian Poets of Tuebingen University, Germany, and colleagues on figures from 1,019 extremely preterm infants in a Canadian trial.
The team looked at the link between episodes of hypoxemia and the risk of death or disability, such as cognitive or language delay, motor impairment, deafness, or blindness, at 18 months.
This showed that hypoxaemic episodes were associated with death or disability in over half (57%) of those who had the most episodes, and 40% of those who experienced the fewest episodes. Results appear in the Journal of the American Medical Association.
"The association between hypoxaemia and adverse neurodevelopmental outcome is consistent with the known association between apnoea, one cause of hypoxaemia, and adverse neurodevelopmental outcomes," the experts write.
"Whether hypoxaemia per se is related to abnormal brain stem conduction time remains to be determined," they add.
Commenting on the study in an editorial, Dr Lex Doyle of the University of Melbourne, Australia, and colleagues write: "If hypoxaemia is proven to cause adverse neurodevelopment, any future interventions to reduce prolonged hypoxaemic episodes, such as doxapram [a respiratory stimulant] or higher doses of caffeine must be evaluated in rigorous randomised clinical trials to minimise exposure to therapies that are useless or even harmful.
"Such trials should have long-term developmental outcome as the primary end point, rather than short-term end points," they state.
Poets, C. F. et al. Association Between Intermittent Hypoxemia or Bradycardia and Late Death or Disability in Extremely Preterm Infants. JAMA 12 August 2015 doi:10.1001/jama.2015.8841
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