Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section.

OBJECTIVES: To study the normal oxygen saturation trends and fetomaternal correlates in healthy term newborns within 30 min of life born by normal vaginal delivery (NVD) and elective cesarean section (CS). MATERIALS AND METHODS: A cross-sectional study was conducted on 200 healthy term newborns born by NVD and elective CS at a tertiary care centre. Routine care as per the Neonatal Resuscitation Program (NRP) 2015 (Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: neonatal resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S543-60) protocol was given and pre-ductal arterial oxygen saturation was assessed by pulse oximetry at different intervals after birth. RESULTS: The mean peripheral oxygen saturation (SpO2) was 85.4%, 90.8%, 94.1%, 95.7%, 96.7% and 97.4% at 5, 10, 15, 20, 25 and 30 min, respectively, after birth. Higher mean SpO2 was observed in NVD compared to elective CS (P<0.005). The mean time for SpO2 to reach >90% was 9.13 min in NVD and 12.31 min in elective CS (P<0.001). Maternal hemoglobin (Hb) (r=-0.15; P<0.01), birth weight (r=-0.125; P<0.05) and Apgar at 10 min (r=0.33; P<0.001) were significantly correlated with SpO2 of newborns at 10 min of life. CONCLUSION: Our study defines normal SpO2 levels in healthy term newborns in the first 30 min of life born by NVD and elective CS. Babies born by NVD had significantly higher SpO2 levels and attained SpO2 >90% faster than those born by elective CS. Maternal Hb, birth weight and Apgar at 10 min were significant factors affecting SpO2 levels of newborns at 10 min of life.

Impaired autonomic function in normotensive obese children.

PURPOSE: To evaluate baroreflex sensitivity and autonomic control in a cohort of normotensive obese (OB) children. METHOD: A cross-sectional investigation, in which, baroreflex sensitivity and autonomic control were evaluated using transfer function and power spectral density analysis (PSDA) of the electrocardiogram and beat-to-beat blood pressures in normotensive OB children and normal weight normotensive controls. All methods used were noninvasive and data were captured while seated and at rest. RESULTS: The OB and control subjects non-obese (NO) were of similar age (OB 9.1±1.9 years vs. NO 9.2±1.4 years). The OB group was classified as having a BMI greater than the 95th percentile adjusted for age and gender, and a NO group with a BMI at or less than the 95th percentile (BMI percentile OB. 97.5±1.3 vs. NO 58.5±24.1). Both groups had similar normotensive blood pressures. T tests revealed that baroreflex sensitivity and HFRR were significantly reduced in the OB 9.2±2.7 vs. 15.2±4.7 (ms/mmHg) and 6.7±1.1 vs. 8.2±1.1 ms2, respectively, while LFSBP and LF/HF ratio were significantly increased in the OB 11.9±5.6 vs. 8.2±4.7 mmHg2 and 1.2±0.7 vs. 0.54±0.3, respectively. CONCLUSIONS: Normotensive OB children exhibited significantly reduced baroreflex sensitivity, parasympathetic control as well as increased sympathetic control when compared with healthy, NO controls. Findings in this investigation raise the awareness that autonomic dysfunction is present in young OB normotensive children.