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Placing preterm infants on their side at birth does not increase 5 min SpO2
  1. Ju Lee Oei
  1. Correspondence to: Dr Ju Lee Oei, Department of Newborn Care, the Royal Hospital for Women, University of New South Wales, Barker Street, Randwick, NSW 2031, Australia; j.oei{at}

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Placing preterm infants on their side appears to improve oxygenation and breathing patterns after1 ,2 and at birth.3 Current neonatal guidelines do not recommend any particular position,4 but previous guidelines5 ,6 suggested that infants could either be placed on their back or their sides during resuscitation or stabilisation. Preterm infants have floppy airways that may exacerbate respiratory distress leading to the assumption in this randomised controlled trial (RCT) that placing preterm infants on their left side would increase aeration and oxygenation even if advanced respiratory care, including continuous positive airway pressure (CPAP) and intubation, were required.


The RCT was conducted in the delivery rooms of three tertiary-level hospitals in Ireland, the Netherlands and Australia. Infants below 32 weeks of gestation were randomised in a 1:1 ratio to be placed on their backs …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.