Effect of position on oxygen saturation and requirement in convalescent preterm infants

Aims:  To document the effect of position on oxygen saturation and changes in oxygen requirement in convalescent preterm infants. Methods:  Twelve infants born ≥24 and ≤32 weeks gestation, extubated and without congenital anomaly were studied using nap polysomnography in prone and supine, twice weekly until discharge. Mean oxygen saturation (SpO 2 ), minimum SpO 2 , mean minimum SpO 2 and time with SpO 2  < 90% were measured in active sleep. Results:  Eight male and four female infants [median gestation 28 (24–31) weeks and median birthweight 1059 (715–1840) g] had 39 studies. For 21 of 39 studies, the infant was on respiratory support. Four infants had chronic lung disease (CLD). SpO 2 varied with postmenstrual age (PMA) (p = 0.003) but not with position (p = 0.36), and PMA did not influence the effect of position on SpO 2 (p = 0.19). SpO 2 was lower for those with CLD (p < 0.0001) and those on respiratory support (p < 0.001), but there was no effect of position (p = 0.97 and p = 0.67, respectively). From 36 weeks PMA, a change to supine did not increase oxygen requirement. Conclusion:  In preterm infants, PMA and residual respiratory disease have greater effects on oxygenation than position. A supine sleep position is not disadvantageous for preterm infants at discharge.