Clinical assessment of infant colour at delivery

Colm Patrick Finbarr O'Donnell ^1*, C. Omar Farouk Kamlin ², Peter Graham Davis ², John B Carlin ³ and Colin J Morley ²

¹ National Maternity Hospital, Dublin, Republic of Ireland
² Royal Women's Hospital, Melbourne, Australia
³ Royal Children's Hospital, Melbourne, Australia

^* To whom correspondence should be addressed. E-mail: codonnell{at}nmh.ie.

Accepted 6 June 2007

Abstract

Objective: Using video recordings of newly born infants, to determine: 1) if clinicians agreed whether infants were pink; and 2) the oxygen saturation (SpO2) at which infants first looked pink.

Methods: We selected clips from video recordings of infants taken immediately after delivery. They received varying degrees of resuscitation (including none) and were monitored with pulse oximetry. The oximeter readings were obscured to observers but known to the investigators. A timer was visible and sound was inaudible. Observers were asked to indicate whether each infant was pink at the beginning, became pink during the clip, or were never pink. If adjudged to turn pink during the clip, observers recorded the time this occurred and the corresponding SpO2 was determined.

Results: Twenty-seven clinicians assessed videos of 20 infants of mean (SD) 31(4) weeks¡ gestation. One infant (5%) was perceived to be pink by all observers. The number of clinicians who thought each of the remaining 19 infants were never pink varied from 1 (4%) to 22 (81%). Infants with a maximum SpO2 ¡ 95% during the clip were considered never to be pink by 16% of the observers. The SpO2 at which individual infants were perceived to turn pink varied from 10% to 100%.

Conclusion: Amongst clinicians observing the same videos there was disagreement about whether newly born infants looked pink and wide variation in the SpO2 when they were considered to become pink.

Keywords: colour, infant, newborn, pulse oximetry, resuscitation

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