TITLE:
Neonatal Hypoxemia in the Neonatal Unit of the Albert Royer National Children’s Hospital in Dakar (Chnear)
AUTHORS:
Chaimaa El Yacoubi, Yousra Hillal, Aida Maryame Kane, Asmae El Fkier, Fatima Zahra Sahib, Alpha Boubacar Diallo, Indou Dème Ly, Babacar Niang, Yaay Joor Koddu Biige Dieng, Amadou Sow, Djibril Boiro, Modou Gueye, Aliou Thiongane, Amadou Lamine Fall, Ousmane Ndiaye, Pape Moctar Faye
KEYWORDS:
Neonatal Hypoxemia, Respiratory Distress, Oxygen Therapy
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.4,
July
9,
2026
ABSTRACT: Introduction: Neonatal hypoxemia corresponds to a decrease in oxygen saturation, defined here as SpO2 ≤ 94% in room air, measured by pulse oximetry and interpreted in conjunction with the initial clinical assessment (Silverman score and signs of respiratory distress). Methods: This was a single-center retrospective observational study with descriptive and comparative analyses, conducted in a Level III neonatal unit at a university hospital from January 1 to December 31, 2024. Pulse oximetry was systematically performed at admission in hospitalized newborns and repeated according to clinical status. All newborns aged 0 to 28 days hospitalized with hypoxemia at admission (SpO2 ≤ 94% in room air) were included. Results: A total of 61 newborns were included, representing 14.73% of neonatal admissions. A slight female predominance was noted (57.38%). Most newborns were admitted within the first 24 hours of life (63.9%) and were referred from another facility (80.33%), most often by ambulance/medical transport (80.33%); low socioeconomic status was common (72.13%). More than half were preterm (54.1%), with a mean gestational age of 34.5 ± 5.1 weeks, and vaginal delivery was predominant (65.57%). At admission, respiratory distress was very common (93.4%), and 14.8% had severe forms (Silverman score > 6). The main diagnoses were neonatal infection (63.93%), prematurity (44.26%), hyaline membrane disease/respiratory distress syndrome (42.62%), congenital heart disease (27.87%), and perinatal asphyxia (21.31%). On chest imaging, cardiomegaly (8.2%) and thoracic hyperinflation (6.6%) were the most common abnormalities. Respiratory support relied mainly on nasal cannula oxygen therapy (59.02%), with use of CPAP (34.43%), endotracheal intubation with mechanical ventilation (31.15%), and high-flow oxygen therapy (18.03%). The mean maximum FiO2 administered reached 95.54%, with a median duration of oxygen therapy of 7 days and a median minimum oxygen saturation of 87%. Outcomes were unfavorable in 63.9% of cases, corresponding to 39 deaths; 22 newborns (36.1%) were discharged alive. Deaths were mainly attributed to neonatal infection (69.23%), followed by hyaline membrane disease (43.58%) and shock-related causes (28.20%; septic shock 15.38% and cardiogenic shock 12.82%). Conclusion: Neonatal hypoxemia in our unit remains frequent and severe, driven by prematurity, infection, and respiratory distress, and is associated with high mortality. These findings highlight the need for early detection through systematic pulse oximetry, safe medical transport, structured oxygen therapy protocols (nasal cannula/CPAP/HFNC/ventilation), effective infection control, and rapid access to echocardiography when congenital heart disease is suspected.