Reference ranges for oxygen saturation

Reference ranges for oxygen saturation in the first 10 minutes following birth

The ability to accurately measure oxygen saturation in the first minutes after birth has enabled the development of oxygen saturation charts from healthy newborn infants who did not receive any interventions in the delivery room. These charts provide useful reference ranges of “normal” saturation in both term and premature newborns. With a better understanding of normoxia in newborn infants, clinicians have more reliable data upon which to base titrating supplemental oxygen administration in the delivery room. It is important to note that all infants in this study had early cord clamping. 

These reference charts and a detailed discussion regarding the differences seen in newborn infants according to their gestational age and mode of birth (vaginal versus caesarean section) is provided by Dawson, et al., (2010).

To summarize the key findings, Dawson, et al., (2010) reported:

  • The median pre-ductal oxygen saturation (SpO2) ranges in all the infants (term and preterm) were:
    • 66% at 1 minute of age
    • 78% at 3 minutes of age
    • 89% by 5 minutes of age
    • 95% by 8 minutes of age
    • 96% by 10 minutes of age
  • The median time at which the infants reached an SpO2 greater than 90% after birth was:
    • 7.6 minutes for term infants
    • 8.1 minutes for preterm infants
  • Preterm infants had lower SpO2 compared to term infants. Their median pre-ductal SpO2 values were:
    • 62% (preterm infants) compared with 68% (term infants) at 1 minute of age
    • 76% (preterm infants) compared with 81% (term infants) at 3 minutes of age
    • 86% (preterm infants) compared with 92% (term infants) at 5 minutes of age
    • 94% (preterm infants) compared with 97% (term infants) at 10 minutes of age
  • Infants born by Caesarean section (C/S) had lower oxygen saturations in comparison to those infants born vaginally. The median SpO2 values of the infants born by Caesarean section were:
    • 54% (C/S) compared with 67% (vaginal birth) at 1 minute of age
    • 67% (C/S) compared with 80% (vaginal birth) at 3 minutes of age
    • 85% (C/S) compared with 92% (vaginal birth) at 5 minutes of age
    • 94% (C/S) compared with 96% (vaginal birth) at 10 minutes of age

Using these data, clinicians can now titrate supplementary oxygen concentrations to appropriate targets during the first ten minutes after birth.

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