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Limited agreement between clinical assessment of infant colour at birth and oxygen saturation in a hospital in Ethiopia
Author(s) -
Cavallin Francesco,
Cori Maria Sofia,
Negash Senait,
Azzimonti Gaetano,
Manenti Fabio,
Putoto Giovanni,
Trevisanuto Daniele
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15463
Subject(s) - medicine , pulse oximetry , oxygen saturation , limits of agreement , saturation (graph theory) , oxygen , pediatrics , zoology , anesthesia , nuclear medicine , chemistry , mathematics , combinatorics , biology , organic chemistry
Aim To evaluate the relationship between clinical assessment of infant colour and oxygen saturation at birth in a low‐resource setting. Methods Classification of infant colour (cyanotic, pink or unclear) by midwives was compared to pulse‐oximeter data at 60‐90‐120‐300 seconds after birth in 60 neonates. Results Overall, oxygen saturation increased over time ( P < .0001) and was different according to infant colour ( P < .0001). Median oxygen saturation in pink infants was 87% at 60 seconds (n = 1), 90% (IQR 83‐91) at 90 seconds (n = 5), 86% (IQR 81‐94) at 120 seconds (n = 11) and 93% (IQR 90‐96) at 300 seconds (n = 20). Median oxygen saturation in cyanotic infants was 60% (IQR 45‐70) at 60 seconds (n = 52), 64% (IQR 52‐69) at 90 seconds (n = 42), 63% (IQR 56‐68) at 120 seconds (n = 35) and 66% (IQR 62‐74) at 300 seconds (n = 22). Median oxygen saturation in unclear‐coloured infants was 57% (IQR 56‐60) at 60 seconds (n = 7), 78% (IQR 71‐81) at 90 seconds (n = 13), 81% (IQR 79‐88) at 120 seconds (n = 14) and 80% (IQR 76‐84) at 300 seconds (n = 18). The proportion of infants with unclear colour ranged from 12% to 30%. Conclusion The variability of oxygen saturation among pink and cyanotic infants, and the substantial proportion of unclear infant colour, suggest the possible benefit of the availability of pulse oximetry in low‐resource settings.