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High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis

Minghua L Chen1, Lei Guo, Lois E H Smith

  • 1Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Box 854, 800 Washington St, Boston, MA 02111-1526, USA. mchen4@tuftsmedicalcenter.org

Pediatrics
|May 26, 2010
PubMed

Insights

Low oxygen saturation in early weeks and high saturation later may reduce severe retinopathy of prematurity (ROP) risk in preterm infants. Further trials are needed to confirm these findings for ROP prevention.

Area of Science:

  • Neonatalogy
  • Ophthalmology
  • Clinical Research

Background:

  • Retinopathy of prematurity (ROP) is a significant concern in preterm infants.
  • Oxygen saturation levels appear to influence ROP risk, with conflicting evidence regarding optimal targets.
  • Previous studies have not provided conclusive evidence on the association between target oxygen saturation and severe ROP incidence.

Purpose of the Study:

  • To systematically review and meta-analyze studies investigating the relationship between target oxygen saturation levels and severe ROP incidence in premature infants.
  • To clarify the association between high or low target oxygen saturation, as measured by pulse oximetry, and the risk of severe ROP.

Main Methods:

  • Comprehensive literature searches of PubMed and Embase were conducted up to May 2009.
  • Ten relevant publications were selected for meta-analysis, focusing on ROP and target oxygen saturation.
  • A random-effects model was employed to calculate the summary effect estimate, and funnel plots were used to assess publication bias.

Main Results:

  • Low oxygen saturation (70%-96%) during the initial postnatal weeks was associated with a reduced risk of severe ROP (RR: 0.48).
  • High oxygen saturation (94%-99%) at or after 32 weeks postmenstrual age (PMA) was linked to a decreased risk of severe ROP progression (RR: 0.54).

Conclusions:

  • Both early low and late high oxygen saturation levels appear to reduce the risk of severe ROP in preterm infants (gestational age ≤32 weeks).
  • These findings suggest a potential role for tailored oxygen saturation targets in ROP management.
  • A large randomized clinical trial with long-term follow-up is recommended to validate these meta-analytic results.
Abstract

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