{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:44:10Z","timestamp":1792511050207,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"\n Importance<\/jats:title>\n \n The optimal initial fraction of inspired oxygen (F\n io<\/jats:sc>\n 2<\/jats:sub>\n ) for delivery room resuscitation of neonates born at 32 to 35 weeks\u2019 gestation is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To compare outcomes for neonates born at 32 to 35 weeks\u2019 gestation when initiating resuscitation with F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 vs 0.21.\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Unblinded, cluster randomized crossover trial in 26 Australian maternity hospitals, including tertiary, nontertiary, metropolitan, regional, public, and private sites, using a waiver of informed consent. All neonates born at participating sites at 32 to 35 weeks\u2019 gestation without known major congenital anomalies who commenced respiratory support within 3 minutes of birth were enrolled from December 2022 to September 2025, with final follow-up in March 2026. Statistical analysis was conducted on October 29, 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n \n Sites were randomly assigned to provide initial F\n io<\/jats:sc>\n 2<\/jats:sub>\n of either 0.30 or 0.21 during the first 3 minutes of delivery room respiratory support. Sites crossed over to provide the alternative initial F\n io<\/jats:sc>\n 2<\/jats:sub>\n halfway through their recruitment period.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was ongoing respiratory support when leaving the delivery room. Twelve secondary outcomes evaluated delivery room treatments and respiratory support until discharge.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1818 eligible newborns (mean gestational age, 34.1 weeks; mean birth weight, 2165 g; 44.7% female) were included. Ongoing respiratory support when leaving the delivery room occurred in 700 of 964 newborns (72.6%) randomized to receive F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 and 626 of 854 newborns (73.3%) randomized to receive F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.21 (risk difference, \u22120.83 [95% CI, \u22124.33 to 2.67]). Of the 12 secondary outcomes, 10 were not significantly different between newborns randomized to receive F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 vs 0.21, while 2 were. Newborns randomized to receive F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 were less likely to receive higher levels of support in the delivery room, including noninvasive positive pressure ventilation (606 of 964 [62.9%] vs 560 of 854 [65.6%]), endotracheal or supraglottic airway ventilation (20 of 964 [2.1%] vs 24 of 854 [2.8%]), or cardiac compressions or epinephrine (19 of 964 [2.0%] vs 25 of 854 [2.9%]; proportional odds ratio, 0.70 [95% CI, 0.52-0.95]). Fewer newborns in the F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 group received endotracheal ventilation beyond the delivery room (61 of 959 [6.4%] vs 79 of 852 [9.3%]; risk ratio, 0.69 [95% CI, 0.47-0.91]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n For neonates born at 32 to 35 weeks\u2019 gestation, there was no difference between those commencing resuscitation with F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.30 vs F\n io<\/jats:sc>\n 2<\/jats:sub>\n 0.21 in the proportion still receiving respiratory support when leaving the delivery room.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n anzctr.org.au Identifier:\n ACTRN12621001267842<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2026.14201","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:00:24Z","timestamp":1788966024000},"page":"1319","source":"Crossref","is-referenced-by-count":1,"title":["Oxygen vs Air at Birth for Moderate- to Late-Preterm Infants"],"prefix":"10.1001","volume":"336","author":[{"given":"Stacey R.","family":"Peart","sequence":"first","affiliation":[{"name":"Newborn Services and Newborn Research, The Royal Women\u2019s Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett J.","family":"Manley","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanie L. Y.","family":"Cheong","sequence":"additional","affiliation":[{"name":"Newborn Services and Newborn Research, The Royal Women\u2019s Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Lee","family":"Oei","sequence":"additional","affiliation":[{"name":"National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia"},{"name":"Discipline of Paediatrics & Child Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke C.","family":"Grobler","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia L.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renae L.","family":"Allen","sequence":"additional","affiliation":[{"name":"Newborn Services and Newborn Research, The Royal Women\u2019s Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria G.","family":"Alda","sequence":"additional","affiliation":[{"name":"Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Bell","sequence":"additional","affiliation":[{"name":"Monash Newborn at Sandringham, Alfred Care Group Bayside Health, Sandringham, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Bhola","sequence":"additional","affiliation":[{"name":"Newborn Care Unit, Blacktown Hospital, Blacktown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystal","family":"Carman","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s, Children\u2019s and Family Health, Royal North Shore Hospital, St Leonards, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koert","family":"de Waal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, John Hunter Children\u2019s Hospital, Newcastle, New South Wales, Australia"},{"name":"University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. A. Niroshan","family":"Dombagahawaththage","sequence":"additional","affiliation":[{"name":"Wimmera Base Hospital, Horsham, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Qi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Northern Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Y. W.","family":"Fang","sequence":"additional","affiliation":[{"name":"Eastern Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasoon K.","family":"Goyadi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Goulburn Valley Hospital, Shepparton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerryn A.","family":"Houghton","sequence":"additional","affiliation":[{"name":"Liverpool Hospital, South Western Sydney Health District, Liverpool, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpesh F.","family":"Jain","sequence":"additional","affiliation":[{"name":"Campbelltown Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jubal","family":"John","sequence":"additional","affiliation":[{"name":"NeoPaeds, Parkville, Melbourne, Victoria, 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