Continuous oxygen saturation and risk of retinopathy of prematurity in a Japanese cohort

We assessed the associations between retinopathy of prematurity (ROP) and continuous measurements of oxygen saturation (SpO₂), and developed a risk prediction model for severe ROP using birth data and SpO₂ data.

This retrospective study included infants who were born before 30 weeks of gestation between August 2009 and January 2019 and who were screened for ROP at a single hospital in Japan. We extracted data on birth weight (BW), birth length, gestational age (GA) and minute-by-minute SpO₂ during the first 20 days from the medical records. We defined four SpO₂ variables using sequential measurements. Multivariate logistic regression was used to develop a model that combined birth data and SpO₂ data to predict treatment-requiring ROP (TR-ROP). The model's performance was evaluated using the area under the receiver operating characteristic curve (AUC).

Among 350 infants, 83 (23.7%) required ROP treatment. The SpO₂ variables in infants with TR-ROP differed significantly from those with non-TR-ROP. The average SpO₂ and high SpO₂ showed strong associations with GA (r=0.73 and r=0.70, respectively). The model incorporating birth data and the four SpO₂ variables demonstrated good discriminative ability (AUC=0.83), but it did not outperform the model incorporating BW and GA (AUC=0.82).

Data obtained by continuous SpO₂ monitoring demonstrated valuable associations with severe ROP, as well as with GA. Differences in the distribution of average SpO₂ and high SpO₂ between infants with TR-ROP and non-TR-ROP could be used to establish efficient cut-off values for risk determination.