Chijioke Iremeka
Citing the importance of early intervention, paediatricians have said delivering oxygen to preterm babies within 10 minutes of birth is crucial for their survival.
The child health experts, however, warned that administering excess oxygen to premature babies could lead to organ failure and brain damage due to their immature lungs.
The physicians emphasised that preterm babies often have underdeveloped lungs, making it difficult for them to breathe effectively on their own, stressing that the right oxygen therapy during this critical period can help stabilise their vital organs, particularly the brain, and heart.
They noted that each preterm infant had unique oxygen needs based on factors like gestational age, weight, and overall health, emphasising that while some may require higher levels of oxygen support, others may need more gentle interventions.
The specialists cautioned the medical teams attending to preterm babies to carefully assess and adjust oxygen delivery to meet the specific requirements of each baby, saying that incorrect oxygen levels, either too high or too low, can lead to serious complications.
A study published in JAMA Pediatrics examined clinical trial data and outcomes of over one thousand premature babies who were given different oxygen concentrations in the first minutes of life.
The research focused on how varying oxygen levels affected the survival and health of preterm infants, revealing that the oxygen needs of premature babies are highly individualised, with each baby requiring a specific oxygen concentration.
It found that both excessive and insufficient oxygen could lead to significant complications, such as brain damage or respiratory failure, highlighting the importance of carefully monitoring and adjusting oxygen delivery in the critical first moments of life.
Speaking exclusively with PUNCH Healthwise in different interviews, the experts emphasised that precise and individualised care in the first 10 minutes of the life of preterm infants was essential to improve survival and reduce long-term health risks.
A Consultant Paediatrician at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Dr Stanley Onah affirmed that oxygen concentration in the first 10 minutes of a preterm infant’s life might mar or make the baby.
He emphasised that high concentrations of oxygen in such a baby could lead to retinopathy of prematurity (eye problems) or periventricular leukomalaciabra (Brain damage), saying that timely and accurate oxygen management is vital to improving the chances of survival and long-term health for preterm infants.
Onah said, “Retinopathy of Prematurity is a condition where abnormal blood vessels grow in the retina, the light-sensitive tissue at the back of the eye. High oxygen levels can affect the normal development of these blood vessels in premature babies, especially those who are born before 31 weeks of gestation.
“The condition can lead to vision problems, and in severe cases, it may result in blindness. However, early detection and careful management of oxygen therapy are crucial in preventing ROP. Laser therapy or injections can help manage ROP and preserve vision if the condition is caught early.”
On the brain damage, he said, “Also, periventricular leukomalacia is a type of brain injury that occurs when there is damage to the white matter around the ventricles, which is crucial for transmitting nerve signals.
“High levels of oxygen, especially when administered inappropriately, can lead to the formation of free radicals, which may damage the developing brain cells in premature infants.
“This condition can lead to motor impairments, cerebral palsy, and other neurological issues. Careful monitoring and regulation of oxygen therapy in preterm infants are essential to minimize the risk of PVL and other related brain injuries.”
Speaking on the treatment and solution, Onah said, “It is crucial to take a preterm baby to a facility equipped with specialised neonatal care units that have the necessary equipment to monitor and determine the correct oxygen levels.
“Some of these facilities are equipped with advanced tools like pulse oximeters to measure oxygen saturation in the blood and capnographs to monitor carbon dioxide levels. Incubators and ventilators are used to regulate the baby’s oxygen intake.
“Medical professionals at these centres can assess the infant’s specific oxygen requirements based on their gestational age, weight, and overall health condition.
“They can then adjust the oxygen delivery accordingly to ensure the baby receives the precise amount needed to support their growth and survival while avoiding the risks of both oxygen deprivation and oxygen toxicity, which can lead to complications like retinopathy of ROP or PVL.”
Sustaining this line of argument, a Consultant Paediatrician at the Life International Hospital, Awka, Anambra State, Dr. Sylvia Echendu said there is no appropriate equipment to handle these cases.
“Some of them don’t have oxygen, incubators, and phototherapy units. Of course, power supply is essential because all this equipment won’t work without electricity. The majority of hospitals where these preterm are born don’t have equipment.
“You don’t have any business being in a facility that does not have the required equipment to save your child when there is likelihood of preterm birth.”
She added that with investment in equipment and education of professionals on neonate care, the preterm mortality rate in Nigeria will be reduced.
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