Oxygen Saturation Target Achievement in Preterm Infants <32 Weeks’ Gestation with 9th Edition NRP Guidelines: A Multicenter Observational Study in Latin America

Objective: To evaluate delivery room oxygen practices based on the 9 ^th edition of Neonatal Resuscitation Program and preductal SpO₂ at 5 minutes in preterm infants <32 weeks’ gestation Study Design: Prospective observational study in 9 centers across 6 Latin-American countries. Data included initial FiO ₂ , changes during stabilization, and SpO₂ at 5 minutes. Results: Among 173 infants, initial FiO ₂ was 0.3 in 71% (range:0.3-1.0). At 5 minutes, 18% were within target (SpO ₂ 80–85%). SpO ₂ was <80% in 16%, between 86-95% in 49% of infants and >95% in 17%. FiO ₂ was increased in 55% and 35% of infants received ≥0.6 FiO ₂ by 5 minutes. Among 41 infants ≤26 weeks, initial FiO ₂ varied (0.3 -71%, 0.4-0.5-12%, 0.6-0.9-15% and 1.0-2%) and was titrated up in 73%. Conclusion: With adaptation of initial FiO ₂ range suggested by 9 ^th edition NRP (0.3-1.0), two-thirds of preterm infants exceeded recommended SpO₂ targets, suggesting potential hyperoxia exposure.