The Use of Overnight Oximetry and Polysomnography in Late Preterm to Term Newborns Requiring Home Oxygen at Discharge
Amelia N. Noone, Tom Goddard, Tara M. Crawford, Chad C. Andersen, Michael J. StarkABSTRACT
Background and Objective
Overnight oximetry is routinely used to assess long‐term oxygen therapy (LTOT) in late preterm and term newborns; however, there is a lack of population‐specific evidence‐based guidelines. This single‐center, retrospective cohort study describes the clinical characteristics and management approach for LTOT in this population.
Methods
Newborns ≥ 34 weeks' gestation born between 2016 and 2024 and discharged on LTOT were identified through databases at the Women's and Children's Hospital. Overnight oximetry, completed before and/or after discharge, and polysomnography results were collected, with the difference between first and second overnight oximetry analyzed using a paired t‐test with Wilcoxon matched‐pairs signed‐rank test.
Results
A total of 148 newborns were identified, with 128 meeting eligibility. The median (range) gestational age was 39 (34–42) weeks, and birthweight was 3590 (1590–4790) grams. Overall, newborns had 2 (1–15) overnight oximetry tests and 1 (1–5) polysomnography tests. Airway malacia was the primary diagnosis (48.1%). While desaturation events occurred in all studies, the total number of desaturations ( p = 0.0008), % time SpO 2 < 90% ( p = 0.002), < 88% ( p = 0.01), and desaturation event index ( p < 0.0001) improved between initial and subsequent oximetry. Median obstructive apnea‐hypopnoea index was 5.7 (1–46)/hr and central apnea index 5.4 (0–87)/hr. LTOT duration was 229 (38–2347) days.
Conclusion
Late preterm and term newborns showed significant improvement on repeat overnight oximetry. Diagnoses and clinical pathways for this cohort remain heterogeneous, with the decision to undertake repeat oximetry not reflecting initial severity, highlighting the need for standardized population‐specific guidelines.