Resuscitation of Late-preterm Infants by Using Room Air or 100% Oxygen

In this randomized control trial, the investigators hypothesize that late-preterm infants resuscitated with a "low oxygen delivery" strategy (initiation of resuscitation with room air) will result in a significant reduction in oxidant stress without any harmful clinical effects.

The delivery of high oxygen concentrations leads to the production of free radicals that can injure many organ systems. Some studies have shown that resuscitation of term newborn infants with room air were safe and of great benefit. A static room air, however, may be inappropriate for resuscitation of preterm infants. The number of late-preterm infants has increased in recent years, which represent approximately 70% of all preterm infants. Our study will evaluate the safety and efficacy of using room air during resuscitation of late-preterm infants and whether this will avoid oxidative stress derived damage and improve outcomes.

Initiation of resuscitation with 21% Oxygen, adjustments to the inspired oxygen concentration (increased 10%) will be made every 60 seconds for infants to achieve a target SpO2 range of 85-92%

Initiation of resuscitation with 100% Oxygen and achieve oxygen saturation in the preset limits 85-92%

Use of inspiratory fraction of oxygen needed to achieve oxygen saturation in the preset limits 85-92%

Inclusion Criteria: inborn infant gestation 34 weeks to 36 weeks 6 days Exclusion Criteria: • known chromosomal or congenital anomalies