Extreme preterm infants (<28 weeks' gestation) often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room. To date, optimal inspired fraction of oxygen (FiO 2) still represents a conundrum in newborn care oscillating between higher (>60%) and lower (<30%) initial FiO 2. Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry ≥85% at 5 minutes after birth. New clinical trials comparing higher versus lower initial FiO 2 have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.

Extreme preterm infants (<28 weeks' gestation) often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room. To date, optimal inspired fraction of oxygen (FiO 2) still represents a conundrum in newborn care oscillating between higher (>60%) and lower (<30%) initial FiO 2. Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry ≥85% at 5 minutes after birth. New clinical trials comparing higher versus lower initial FiO 2 have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.