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Oxygen saturation levels and retinopathy of prematurity in extremely preterm infants - a case control study

Varnika Aggarwal1, Risha Bhatia1,2, Kenneth Tan3,4

  • 1Department of Paediatrics, Monash University, Melbourne, Australia.

BMC Pediatrics
|September 8, 2023
PubMed

Insights

This study found that while oxygen exposure did not significantly influence retinopathy of prematurity (ROP) risk in preterm infants, neonatal surgery was a significant risk factor. Further research into ROP development is crucial for premature infants.

Area of Science:

  • Neonatal Medicine
  • Ophthalmology
  • Pediatric Critical Care

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • Identifying risk factors for ROP is crucial for timely intervention and prevention strategies.
  • Oxygen exposure is a known, but complex, factor in ROP development.

Purpose of the Study:

  • To investigate the association of risk factors, including oxygen exposure, for developing retinopathy of prematurity (ROP) in preterm infants.
  • To analyze the impact of oxygen delivery methods, saturation levels, and inspired oxygen fractions on ROP incidence.
  • To determine the role of neonatal surgery as a potential risk factor for ROP.

Main Methods:

  • A case-control study matching 123 infants with ROP to controls without ROP, born at < 28 weeks gestation.
  • Collection of clinical data from electronic medical records, including oxygen delivery, SpO2, FiO2, and MAP.
  • Time-averaged SpO2 analysis using MATLAB and statistical analysis using Stata/SE 16.0.

Main Results:

  • The ROP group spent more time in hyperoxia than the non-ROP group (p < 0.001).
  • No significant difference in SpO2 was observed between groups when receiving oxygen support (FiO2 > 21%).
  • Neonatal surgery significantly increased ROP risk (OR = 1.4347, p = 0.010), while birthweight and oxygen exposure showed negligible influence.

Conclusions:

  • Oxygen saturation levels did not differ between ROP and non-ROP groups during respiratory support.
  • Neonatal surgery emerged as a significant risk factor associated with an increased likelihood of developing ROP.
  • The study highlights the importance of considering surgical interventions as a risk factor in ROP pathogenesis.
Abstract

Keywords:
InfantsNewborn; pretermOxygen exposureOxygen saturationRetinopathy of prematurity

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