The Incubator #386 - 🟢 HOT TOPICS 2025 COVERAGE - Should Moderate Preterm Infants Start with Higher Oxygen at Birth?
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Dec 8, 2025 Dr. Louise Owen dives into the AEROPLANE trial, exploring whether moderate preterm infants should start with higher oxygen at birth. This critical study highlights that infants receiving 30% oxygen required fewer interventions like assisted ventilation. Surprisingly, many infants who needed initial support continued to require it later. The findings suggest that these moderate preterms may behave more like very preterm infants regarding oxygen needs, prompting a reevaluation of resuscitation practices in this significant but often overlooked group.
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Guidelines And New Trials Are Shifting Oxygen Practice
- Recent high-quality trials and guideline changes prompted re-evaluation of oxygen policies for preterm resuscitation.
- The moderate preterm group (32–35 weeks) has been understudied and may need different oxygen strategies than term babies.
The 32–35 Week Group Is A Research Black Hole
- The 32–35 week cohort was a 'black hole' in research with fewer than 100 previously studied infants.
- This group represents most preterm births globally and deserves targeted trials to guide practice.
Design Pragmatic Delivery-Room Trials For Real-World Use
- Use cluster randomization and waived consent for large pragmatic delivery-room trials to include births across varied centers.
- Design studies as comparative-effectiveness of existing care when genuine equipoise exists to enable real-world implementation.