What does this research mean for the field?

Hypoxaemia, including both severe (SpO2 <90%) and mild (SpO2 90-94%) levels, is strongly associated with increased mortality in children with lower respiratory infections in low- and middle-income countries. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To update global risk estimates of the association between hypoxaemia and mortality in children younger than 5 years with lower respiratory infections in LMICs across multiple SpO2 thresholds.

September 3, 2026The Lancet Global HealthOpen Access

Hypoxaemia and mortality in children with lower respiratory infection in low-income and middle-income countries: systematic review and meta-analysis

Q: What question did this study set out to answer?

To update global risk estimates of the association between hypoxaemia and mortality in children younger than 5 years with lower respiratory infections in LMICs across multiple SpO2 thresholds.

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Authors

NHNadia E HoekstraUniversity of North Carolina at Chapel Hill KJKristen S JosephJohns Hopkins University HSHolly B. SchuhJohns Hopkins University

Discussion

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Overview

Systematic review and meta-analysis finds significantly increased mortality from hypoxaemia in young children with respiratory infections, highlighting the need to treat milder oxygen deficits.

Key Points

To update global risk estimates of the association between hypoxaemia and mortality in children younger than 5 years with lower respiratory infections in LMICs across multiple SpO2 thresholds.
Searched six biomedical databases from January 1, 2015, to June 18, 2025, combining 26 new studies with 18 studies from a prior 2015 systematic review.
Included 33 studies evaluating 155,633 children younger than 5 years across Africa and Asia in a random-effects meta-analysis (PROSPERO CRD42023433946).
Hypoxaemia at any threshold was associated with significantly increased odds of mortality compared with normal oxygen saturation (OR 4.36, 95% CI 3.52–5.39; I² 64–85%).
Mortality was markedly higher for SpO2 <90% versus 90–100% (OR 4.75, 95% CI 3.42–6.58) and was also more than doubled for mild hypoxaemia with SpO2 90–94% versus 95–100% (OR 2.27, 95% CI 1.22–4.25).

Cite This Study

Hoekstra et al. (2026) studied this question.

synapsesocial.com/papers/6a9935b1636c6408cfa7e1f1 https://doi.org/10.1016/j.langlo.2026.104031

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September 3, 2026The Lancet Global HealthOpen Access

Hypoxaemia and mortality in children with lower respiratory infection in low-income and middle-income countries: systematic review and meta-analysis

View Full Paper

Ask AI

Bookmark

Authors

NHNadia E HoekstraUniversity of North Carolina at Chapel Hill KJKristen S JosephJohns Hopkins University HSHolly B. SchuhJohns Hopkins University

Discussion

Member takes

Overview

Systematic review and meta-analysis finds significantly increased mortality from hypoxaemia in young children with respiratory infections, highlighting the need to treat milder oxygen deficits.

Key Points

To update global risk estimates of the association between hypoxaemia and mortality in children younger than 5 years with lower respiratory infections in LMICs across multiple SpO2 thresholds.
Searched six biomedical databases from January 1, 2015, to June 18, 2025, combining 26 new studies with 18 studies from a prior 2015 systematic review.
Included 33 studies evaluating 155,633 children younger than 5 years across Africa and Asia in a random-effects meta-analysis (PROSPERO CRD42023433946).
Hypoxaemia at any threshold was associated with significantly increased odds of mortality compared with normal oxygen saturation (OR 4.36, 95% CI 3.52–5.39; I² 64–85%).
Mortality was markedly higher for SpO2 <90% versus 90–100% (OR 4.75, 95% CI 3.42–6.58) and was also more than doubled for mild hypoxaemia with SpO2 90–94% versus 95–100% (OR 2.27, 95% CI 1.22–4.25).

Cite This Study

Hoekstra et al. (2026) studied this question.

synapsesocial.com/papers/6a9935b1636c6408cfa7e1f1 https://doi.org/10.1016/j.langlo.2026.104031

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