Prophylactic intrapartum maternal nasal oxygen for better obstetric and neonatal outcomes
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Abstract
Background: Low Apgar scores remain a leading, modifiable contributor to early-neonatal morbidity in low-resource settings. Whether routine intrapartum maternal oxygen benefits normoxic term pregnancies is uncertain. This study assessed the effect of continuous low-flow nasal oxygen on immediate neonatal outcomes.
Methods: In a prospective, quasi-experimental study at a tertiary hospital in central India, 84 women with term singleton pregnancies (37–42 weeks) were alternately allocated to receive either 4–6 L min⁻¹ nasal oxygen throughout active labour (n = 42) or no supplemental oxygen (n = 42). Baseline socio-demographic and obstetric variables were comparable. Primary outcomes were 1- and 5-minute Apgar scores. Secondary outcomes included improvement in fetal-heart-rate (FHR) tracings, mode of delivery and neonatal-intensive-care-unit (NICU) admission. Pearson’s χ² and independent-samples t tests were applied (α = 0.05).
Results: Oxygen significantly reduced low Apgar prevalence. At 1 minute, scores < 7 occurred in 40.5 % versus 66.7 % of controls (χ² = 5.77, p = 0.016); at 5 minutes, 9.5 % versus 35.7 % (χ² = 8.19, p = 0.004). Mean Apgar values were higher in the oxygen group (1 min: 8.83 ± 1.75 vs 7.83 ± 1.71, p = 0.010; 5 min: 9.81 ± 1.23 vs 7.21 ± 1.39, p = 0.041). FHR tracings improved in 71.4 % versus 19.0 % (p = 0.040); caesarean delivery fell to 23.8 % from 52.4 % (p = 0.007); NICU admission declined from 45.2 % to 7.1 % (p< 0.001). No adverse maternal events were observed.
Conclusions: Continuous 4–6 L min⁻¹ intrapartum nasal oxygen markedly improves 1- and 5-minute Apgar scores, stabilises FHR, halves emergency caesareans and cuts NICU admissions in term singleton births. This inexpensive intervention offers a practical bridge when expedited delivery is delayed, supporting its judicious use in similar settings.
Keywords:
Apgar score, Intrapartum Oxygen, Cesarean for fetal distress, Maternal Nasal Oxygen.
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