Background To reduce the risks of hypoxia and hyperoxia in preterm infants in the delivery room; national and international guidelines recommend titrating supplemental oxygen delivery to achieve specific oxygen saturation (SpO₂) targets. Our aim was to measure the proportion of time infants <32 weeks' gestation spent within and outside prescribed SpO₂ targets during the first 10 min after birth.

Method Prospective observational study using data from a preductal SpO₂ sensor and oxygen analyser measuring fraction of inspired oxygen (FiO₂) in the inspiratory limb of the respiratory circuit. Measurements of SpO₂, heart rate and FiO₂ were recorded every 2 s. We assessed compliance with the upper SpO₂ limit only when infants were receiving supplemental oxygen. SpO₂ measurements were recorded as being below, within or above the target at each time point. We measured the number of times infants were continuously below or above the target range for more than 30 s.

Results Twenty-seven infants; mean (SD) 28 (3.4) weeks and 962 (370) g were studied. Infants were below, within and above the prescribed targets for 28%, 35% and 37% of the first 10 min after birth, respectively.

Conclusions Preterm infants spent almost two-thirds of the first 10 min after birth with oxygen saturations outside prescribed target ranges. New titration strategies are required to reduce the risks of hypoxia and hyperoxia.