Resuscitation of Newborn Infants With 21% or 100% Oxygen: Follow-Up at 18 to 24 Months
* Department of Pediatric Research, Rikshospitalet, University of Oslo, Oslo, Norway
Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
Department of Pediatrics, King Edward Memorial Hospital, Mumbai, India
¶ Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
|| Department of Pediatrics, Santo Thomas University Hospital, Manila, The Philippines
** Department of Pediatrics, Hospital Virgen del Consuelo, Valencia, Spain
Children’s Hospital, Tartu University, Tartu, Estonia
Department of Pediatrics, Vestfold Sentralsykehus, Tønsberg, Norway
¶¶ Section of Medical Statistics, University of Oslo, Oslo, Norway
Objective. To follow-up children who had been resuscitated at birth with either 21% or 100% oxygen (O2).
Methods. A multicenter study with 10 participating centers recruited 609 infants to the Resair 2 study where resuscitation was performed with either 21% or 100% O2. A follow-up between ages 18 and 24 months was performed. However, during follow-up registration, it was found that 18 infants had been enrolled twice in the original Resair 2 study with different registration numbers, leaving 591 enrolled in the Resair 2 study and 410 enrolled in the 7 centers participating in the follow-up. Of these 410 infants, 79 died (76 in the neonatal and 3 in the postneonatal period). Furthermore, for 8 infants informed consent was not obtained, leaving 323 eligible for follow-up. Of these, 213 infants (66%) were followed-up: 91 (62%) had been resuscitated with 21% O2, and 122 (69%) with 100% O2. At a median age of 22 and 20 months (not significant) in the 21% and 100% groups, respectively, a simple questionnaire was filled out and neurologic assessment was performed in addition to measuring anthropometric data.
Results. There were no significant differences in weight, height, or head circumference between the 2 groups. Cerebral palsy developed in 10% and 7%, respectively, in the 2 groups (not significant). In total, 11 cases (12%) in the 21% versus 11 cases (9%) in the 100% O2 group (odds ratio: 1.39, 95% confidence interval: 0.57–3.36) developed cerebral palsy and/or mental or other delay. Furthermore, it was concluded that 14 (15%) in the 21% group and 12 (10%) in the 100% group were not normal (odds ratio: 1.67, 95% confidence interval: 0.73–3.80).
Conclusions. There were no significant differences in somatic growth or neurologic handicap at an age of 18 to 24 months in infants resuscitated with either 21% or 100% O2 at birth. Based on these data, resuscitation with ambient air seems to be safe, at least in most cases. More studies are needed to settle this issue.
Key Words: follow-up • newborn • resuscitation • 21% O2 • 100% O2
Abbreviations: O2, oxygen • OR, odds ratio • CI, confidence interval • CP, cerebral palsy • NS, not significant
Received for publication May 16, 2002; Accepted Jan 6, 2003.
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