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Neonatal oxygen saturations and blood pressure at school-age in children born extremely preterm: a cohort study

Journal of Perinatology volume 40, pages 902–908 (2020)Cite this article

Subjects

Abstract

Objective

To explore the relationship between neonatal oxygen saturation and BP at age 6–7 years in a cohort of infants born extremely preterm.

Study design

Infants <28 weeks gestation were assigned to a higher or lower oxygen saturation target. Oximeter data were monitored throughout the neonatal period. A subset of survivors was seen at age 6. BP was measured and compared by group assignment, achieved saturations, and time spent in hypoxemia (saturations <80%).

Results

There was no difference in systolic or diastolic BP between assigned groups. Median achieved weekly oxygen saturation was not associated with BP. Longer duration of hypoxemia during the first week of age was associated with higher systolic BP.

Conclusions

Neither target nor actual median oxygen saturations in this study was associated with BP at school age. Increased duration of hypoxemia in the first postnatal week was associated with higher systolic BP at 6–7 years of age.

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Fig. 1: Study population.
Fig. 2: Duration of hypoxemia in the first week and SBP.

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Acknowledgements

The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Heart, Lung, and Blood Institute (NHLBI) provided grant support for the Neonatal Research Network’s Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort through cooperative agreements. While NICHD staff had input into the study design, conduct, analysis, and manuscript drafting, the comments and views of the authors do not necessarily represent the views of the NICHD. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, Drs. Abhik Das (DCC Principal Investigator), Marie Gantz, and Barbara Do (DCC Statisticians) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. The following investigators, in addition to those listed as authors, participated in this study: NRN Steering Committee Chairs: Alan H. Jobe, MD PhD, University of Cincinnati (2003-2006); Michael S. Caplan, MD, University of Chicago, Pritzker School of Medicine (2006-2011); Richard A. Polin, MD, Division of Neonatology, College of Physicians and Surgeons, Columbia University, (2011-present). Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island (U10 HD27904) – Abbot R. Laptook, MD; Angelita M. Hensman, MS RNC-NIC; Victoria E. Watson, MS CAS; Elisabeth C. McGowan, MD; Elisa Vieira, RN BSN; Emilee Little, RN BSN; Katharine Johnson, MD; Barbara Alksninis, PNP; Mary Lenore Keszler, MD; Andrea M. Knoll; Theresa M. Leach, MEd CAES; Victoria E. Watson, MS CAS. Case Western Reserve University, Rainbow Babies & Children’s Hospital (U10 HD21364, M01 RR80) – Michele C. Walsh, MD MS; Maureen Hack, MD (deceased); H. Gerry Taylor, PhD; Deanne E. Wilson-Costello, MD; Allison Payne, MD MSCR; Nancy S. Newman, RN; Bonnie S. Siner, RN; Arlene Zadell, RN; Julie DiFiore, BS; Monika Bhola, MD; Harriet G. Friedman, MA; Gulgun Yalcinkaya, MD. Cincinnati Children’s Hospital Medical Center (UG1 HD27853) – Kurt Schibler MD; Kimberly Yolton, PhD; Department of Diagnostic Imaging and Radiology, Children’s National Medical Center, Washington DC – Dorothy Bulas, MD. Duke University School of Medicine, University Hospital, and Duke Regional Hospital (U10 HD40492, M01 RR30) – Ronald N. Goldberg, MD; C. Michael Cotten, MD MHS; Ricki F. Goldstein, MD; Kathryn E. Gustafson, PhD; Ricki F. Goldstein, MD; Patricia Ashley, MD; Kathy J. Auten, MSHS; Kimberley A. Fisher, PhD FNP-BC IBCLC; Katherine A. Foy, RN; Sharon F. Freedman, MD; Melody B. Lohmeyer, RN MSN; William F. Malcolm, MD; David K. Wallace, MD MPH. Emory University, Children’s Healthcare of Atlanta, Grady Memorial Hospital, and Emory Crawford Long Hospital (U10 HD27851, RR25008, M01 RR39) – David P. Carlton, MD; Barbara J. Stoll, MD; Ira Adams-Chapman, MD; Susie Buchter, MD; Anthony J. Piazza, MD; Sheena Carter, PhD; Sobha Fritz, PhD; Ellen C. Hale, RN BS CCRC; Amy K. Hutchinson, MD; Maureen Mulligan LaRossa, RN; Yvonne Loggins, RN, Diane Bottcher, RN.

Eunice Kennedy Shriver National Institute of Child Health and Human Development – Stephanie Wilson Archer, MA.

Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services (U10 HD27856, M01 RR750) – Brenda B. Poindexter, MD MS; Gregory M. Sokol, MD; Heidi M. Harmon, MD MS; Lu-Ann Papile, MD; Abbey C. Hines, PsyD; Leslie D. Wilson, BSN CCRC; Dianne E. Herron, RN; Lucy Smiley, CCRC.

McGovern Medical School at The University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital (U10 HD21373) – Kathleen A. Kennedy, MD MPH; Jon E. Tyson, MD MPH; Andrea Freeman Duncan, MD; Allison G. Dempsey, PhD; Janice John, CPNP; Patrick M. Jones, MD MA; M. Layne Lillie, RN BSN; Saba Siddiki, MD; Daniel K. Sperry, RN.

National Heart, Lung, and Blood Institute – Mary Anne Berberich, PhD; Carol J. Blaisdell, MD; Dorothy B. Gail, PhD; James P. Kiley, PhD.

RTI International (U10 HD36790) – Dennis Wallace, PhD; Marie G. Gantz, PhD; Carla M. Bann, PhD; Jamie E. Newman, PhD MPH; Jeanette O’Donnell Auman, BS; Jane A. Hammond, PhD; W. Kenneth Poole, PhD (deceased).

Stanford University and Lucile Packard Children's Hospital (U10 HD27880, UL1 RR25744, M01 RR70) – Krisa P. Van Meurs, MD; David K. Stevenson, MD; Patrick D. Barnes, MD; Maria Elena DeAnda, PhD; M. Bethany Ball, BS CCRC; Gabrielle T. Goodlin, BAS.

Tufts Medical Center, Floating Hospital for Children (U10 HD53119, M01 RR54) – Ivan D. Frantz III, MD; John M. Fiascone, MD; Elisabeth C. McGowan, MD; Anne Furey, MPH; Brenda L. MacKinnon, RNC; Ellen Nylen, RN BSN; Ana Brussa, MS OTR/L; Cecelia Sibley, PT MHA.

University of Alabama at Birmingham Health System and Children’s Hospital of Alabama (U10 HD34216, M01 RR32) – Waldemar A. Carlo, MD; Namasivayam Ambalavanan, MD; Myriam Peralta-Carcelen, MD; Monica V. Collins, RN BSN MaEd; Shirley S. Cosby, RN BSN; Vivien A. Phillips, RN BSN; Kristy Domanovich, PhD; Sally Whitley, MA OTR-L FAOTA; Leigh Ann Smith CRNP, Carin R. Kiser, MD.

University of California – San Diego Medical Center and Sharp Mary Birch Hospital for Women (U10 HD40461) – Neil N. Finer, MD; Yvonne E. Vaucher, MD MPH; Donna Garey, MD MPH; Maynard R. Rasmussen; MD; Paul R. Wozniak, MD; Martha G. Fuller, PhD RN; Natacha Akshoomoff, PhD; Wade Rich, BSHS RRT; Kathy Arnell, RNC; Renee Bridge, RN.

University of Iowa (U10 HD53109, UL1 TR442, M01 RR59) – Edward F. Bell, MD; Tarah T. Colaizy, MD; John A. Widness, MD; Jonathan M. Klein, MD; Karen J. Johnson, RN BSN; Michael J. Acarregui, MD; Diane L. Eastman, RN CPNP MA; Tammy L. V. Wilgenbusch, PhD.

University of New Mexico Health Sciences Center (U10 HD53089, M01 RR997) – Robin K. Ohls, MD; Janell Fuller, MD; Jean Lowe, PhD; Julie Rohr, MSN RNC CNS; Conra Backstrom Lacy, RN; Rebecca Montman, BSN; Sandra Brown, RN BSN.

University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, and Children's Medical Center Dallas (U10 HD40689, M01 RR633) – Pablo J. Sánchez, MD; Charles R. Rosenfeld, MD; Walid A. Salhab, MD; Roy J. Heyne, MD; Luc Brion, MD; Sally S. Adams, MS RN CPNP; James Allen, RRT; Laura Grau, RN; Alicia Guzman; Gaynelle Hensley, RN; Elizabeth T. Heyne, PsyD PA-C; Jackie F. Hickman, RN; Melissa H. Leps, RN; Linda A. Madden, RN CPNP; Melissa Martin, RN; Nancy A. Miller, RN; Janet S. Morgan, RN; Araceli Solis, RRT; Lizette E. Lee, RN; Catherine Twell Boatman, MS CIMI; Diana M Vasil, MSN BSN RNC-NIC.

University of Utah Medical Center, Intermountain Medical Center, LDS Hospital, and Primary Children's Medical Center (U10 HD53124, M01 RR64) – Bradley A. Yoder, MD; Roger G. Faix, MD; Sarah Winter, MD; Shawna Baker, RN; Karen A. Osborne, RN BSN CCRC; Carrie A. Rau, RN BSN CCRC; Sean Cunningham, PhD; Ariel Ford, PhD.

Wayne State University, Hutzel Women’s Hospital, and Children’s Hospital of Michigan (U10 HD21385) – Athina Pappas, MD; Beena G. Sood, MD MS; Rebecca Bara, RN BSN; Thomas L. Slovis, MD (deceased); Elizabeth Billian, RN MBA; Laura A. Goldston, MA; Mary Johnson, RN BSN.

Funding

The National Institutes of Health (M01 RR30, M01 RR32, M01 RR39, M01 RR54, M01 RR59, M01 RR64, M01 RR80, M01 RR70, M01 RR633, M01 RR750, M01 RR997, UL1 RR25008, UL1 RR25744, UL1 TR442), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (U10 HD21364, U10 HD21385, U10 HD21373, U10 HD27851, U10 HD27856, U10 HD27880, U10 HD27904, U10 HD34216, U10 HD36790, U10 HD40461, U10 HD40492, U10 HD40689, U10 HD53089, U10 HD53109, U10 HD53119, U10 HD53124), and the National Heart, Lung, and Blood Institute (NHLBI) (via co-funding) provided grant support for the NRN’s Extended follow-up at School Age for the SUPPORT NEURO Cohort.

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Authors and Affiliations

  1. Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA

    Marina S. Oren, Vlad Ianus & Kristi L. Watterberg

  2. Department of Pediatrics, Brown University, Providence, RI, USA

    Betty R. Vohr

  3. Department of Pediatrics, Stanford University, Palo Alto, CA, USA

    Susan R. Hintz

  4. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA

    Barbara T. Do

  5. Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA

    Abhik Das

  6. Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA

    Seetha Shankaran

  7. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Rosemary D. Higgins

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  1. Marina S. Oren
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For the Eunice Kennedy Shrive National Institute of Child Health and Human Development Neonatal Research Network

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Correspondence to Kristi L. Watterberg.

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Oren, M.S., Ianus, V., Vohr, B.R. et al. Neonatal oxygen saturations and blood pressure at school-age in children born extremely preterm: a cohort study. J Perinatol 40, 902–908 (2020). https://doi.org/10.1038/s41372-020-0619-z

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