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The AIROPLANE trial aims to understand how doctors can best support the breathing of premature babies born between 32 and 35 weeks of pregnancy, immediately after birth in the delivery room.

The best possible management of newborns requiring breathing support in the delivery room remains a critical area of newborn research. International resuscitation guidelines have changed dramatically over the last 20 years as research has produced more evidence-based practices.

Until now, term babies (born after 37 weeks of pregnancy), and extremely preterm babies (born before 28 weeks of pregnancy) have been the focus of research in the delivery room. However, with almost 1 in 10 babies being born premature in Australia, and most of those being born after 32 weeks of pregnancy, it is important to continue to research the best way to care for all preterm newborns.

There is currently uncertainty in the care of moderate and late preterm infants (babies born between 32 and 35 weeks pregnancy) and a lack of agreement internationally in the optimal starting oxygen concentration to use when supporting these babies at birth.

At the moment, doctors at maternity hospitals in Victoria use a range of oxygen treatments when breathing support is needed at birth for these babies. About half of the hospitals and their staff start breathing support using 21% oxygen (this is the same as the air we all breathe), about a quarter of hospitals would start with 30% oxygen, and the remainder recommend starting in the range of 21-30%, leaving the choice of oxygen concentration within this range to the doctor in charge (unpublished survey data).

The AIROPLANE Trial compares two different initial oxygen concentrations to help support breathing in the first few minutes after birth. We will assess whether either approach leads to babies having less need for breathing support or oxygen treatment beyond the first few minutes of life or spending less time in hospital.

The AIROPLANE team are passionate, dedicated clinicians and experienced researchers at the Royal Women’s Hospital, Melbourne. They care for babies in the Neonatal Intensive Care Unit every day. Our hope is that the results from the AIROPLANE Trial will provide doctors with robust evidence on which to base their everyday practice when caring for these precious babies.