Is oxygen therapy in premature babies linked to cerebral palsy? Not directly, but giving too little oxygen during treatment can raise the risk by causing low oxygen levels in the brain, known as hypoxemia.
Premature infants, or preemies, often need extra oxygen because their lungs are not fully developed. Doctors aim for oxygen saturation levels, measured as SpO2, between 90% and 95% to keep the baby safe. This range helps avoid both low oxygen, which harms the brain, and too much oxygen, which can lead to eye problems like retinopathy of prematurity or lung issues.[1]
Low oxygen, or desaturation below 80% to 85%, must be prevented. It can damage brain areas that control movement, increasing the chance of cerebral palsy later on. Studies show that preemies on supplemental oxygen face a threefold higher risk of these low oxygen episodes compared to those breathing room air, so close monitoring is key.[1]
On the other hand, keeping SpO2 above 95% raises risks of other complications, but it does not directly cause cerebral palsy. Cerebral palsy in preemies more often stems from oxygen lack at birth, infections, bleeding in the brain, or severe jaundice. For example, birth complications like cord problems or delayed delivery can cut off oxygen supply, leading to brain injury.[3][5]
Preemies are at higher risk overall for cerebral palsy, making up 33% to 50% of cases. Factors like preterm birth, low birth weight, and infections add to this. Infections during birth or NICU stays can reduce brain oxygen flow through swelling or toxins.[4]
During the first weeks, when eyes are most at risk, oxygen targets are tricky. Lower targets like 85% to 89% cut eye damage but may boost death risk, while 91% to 95% seems safer for brain health. After that risky period, higher levels of 95% or more help prevent lung problems.[1]
Tools like caffeine citrate can aid by boosting breathing and brain oxygen without extra ventilators.[7] New tech, such as a swimming cap with light and ultrasound sensors, spots brain oxygen changes early to protect at-risk preemies.[2]
Doctors balance these risks by watching work of breathing, heart rates, and saturation closely. This careful approach during oxygen therapy helps lower cerebral palsy odds from low oxygen events.
Sources
https://www.droracle.ai/articles/660629/at-what-oxygen-saturation-level-in-room-air-does
https://www.cerebralpalsyguide.com/blog/new-swimming-cap-early-diagnosis-of-cerebral-palsy-in-infants/
https://www.nationalbirthinjurylaw.com/ataxic-cerebral-palsy
https://www.pediatricorthopedicdoctor.in/2025/12/25/severe-infections-in-infants-leading-to-cerebral-palsy-causes-early-signs-and-prevention/
https://cchp.ucsf.edu/resources/fact-sheets-families/cerebral-palsy
https://www.beamlegalteam.com/blog/birth-injuries-in-multiples-why-twins-and-triplets-face-higher-risks/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12756483/
https://childrenscerebralpalsy.com/news/
