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Hypoxemia in infants with trisomy 21 in the neonatal intensive care unit

Abstract

Objective

Newborns with trisomy 21 (T21) often require NICU hospitalization. Oxygen desaturations are frequently observed in these infants, even in the absence of congenital heart defects (CHD). We hypothesized that NICU patients with T21 have more hypoxemia than those without T21.

Design

All infants with T21 without significant CHD discharged home from the NICU between 2009 and 2018 were included (n = 23). Controls were matched 20:1 for gestational age and length of stay. We compared daily severe hypoxemia events (SpO2 < 80% for ≥10 s) for the whole NICU stay and the pre-discharge week.

Results

Infants with T21 showed significantly more daily hypoxemia events during their entire NICU stay (median 10 versus 7, p = 0.0064), and more so in their final week (13 versus 7, p = 0.0008).

Conclusion

NICU patients with T21 without CHD experience more severe hypoxemia events than controls, particularly in the week before discharge. Whether this hypoxemia predicts or contributes to adverse outcomes is unknown.

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Fig. 1: SpO2 trend in a representative infant with T21 and without T21.
Fig. 2: Distribution of all SpO2 values 60–80%.
Fig. 3: Number of events of desaturation <80% per day for infants with and without T21.

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Funding

NICHD R01HD072071.

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Correspondence to Karen D. Fairchild.

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Krahn, K.N., Nagraj, V.P., McCulloch, M.A. et al. Hypoxemia in infants with trisomy 21 in the neonatal intensive care unit. J Perinatol 41, 1448–1453 (2021). https://doi.org/10.1038/s41372-021-01105-7

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