[8315.5] Follow up for 12-15 Months of Children Resuscitated at Delivery with 21% or 100% Oxygen
Adrian Ioan Toma, Dinu Florin Albu, Ruxandra Mitu, Eugen Matu. Neonatology, Panait Sarbu Hospital, Bucharest, Romania; Obstetrics, Panait Sarbu Hospital, Bucharest, Romania.
BACKGROUND: Controversy exists regarding the long term effects of the use of 21% oxygen in the resuscitation of the term newborn.
OBJECTIVE: To assess the development at 12-15 months of age of the children resuscitated at birth with 21% or 100% oxygen.
DESIGN/METHODS: This was a 12-15 months follow-up study of term newborns in need for resuscitation at birth (at least bag and mask ventilation). Resuscitation was performed according to the guidelines of AAP AHA , except that children were randomized to be given either 100% oxygen (27 cases) or 21% oxygen (27 cases). There were followed: weight, height and head circumference, the Amiel Tison (AT) neurological exam at discharge and the BINS (Bayley Infant Neurodevelopmental Screener) test at 4, 7-10, 11-15 months ( the total score, the risk group, the scores obtained at different items). There were noted also the age when the head control (days) and walking (months) occurred. For comparisons between the 2 samples Chi Square test was used for nominal variables and student test for continuous variables. Kaplan-Meier plots were used for occurrence of milestones.
RESULTS: The Amiel Tison neurological exam at discharge showed significantly more abnormalities in the 100% oxygen group (14/27) (p<0.0016) than in the 21% oxygen group (3/27). The main difference consisted in a deficiency of head flexors tone (7/27 in the 100% oxygen group and 1/27 in the 21% oxygen group) (p<0.0226). In the case of BINS test, at 7-10 months there were significantly more abnormal results(moderate and high risk) in the 100% oxygen group (11/27) than in the 21% oxygen group (5/27) (p< 0.0229) . At the 11-15 months examination, this difference did not occur : 6/27- 100% oxygen group, 5/27- 21% oxygen group). The mean age for head control was significantly lower for newborns in the 21% oxygen group (54 days (SD-16 days) than for those in the 100% oxygen group (68 days (SD-18 days) (p< 0.0236). There was no difference in the age of walking and in the anthropometric indices between the 2 groups at 15 months.
CONCLUSIONS: Abnormalities in neck flexors tone and head control were found with a significantly increased frequency in the newborns resuscitated with 100% oxygen than in those resuscitated with 21% oxygen, but the age for walking and the BINS scores at 15 months did not differ significantly between the 2 groups.