RT Journal Article
SR Electronic
T1 Achieved oxygen saturations and retinopathy of prematurity in extreme preterms
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 138
OP 144
DO 10.1136/archdischild-2018-316464
VO 105
IS 2
A1 Marie G Gantz
A1 Waldemar A Carlo
A1 Neil N Finer
A1 Wade Rich
A1 Roger G Faix
A1 Bradley A Yoder
A1 Michele C Walsh
A1 Nancy S Newman
A1 Abbott Laptook
A1 Kurt Schibler
A1 Abhik Das
A1 Rosemary D Higgins
A1 ,
YR 2020
UL http://fn.bmj.com/content/105/2/138.abstract
AB Objective To identify achieved oxygen saturations (SpO2) associated with increased risk of severe retinopathy of prematurity (ROP).Design This is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO2 was recorded up to 36 weeks’ postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.Setting 20 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.Patients 984 surviving infants of 24–27 weeks’ gestational age born in 2005–2009.Interventions SUPPORT targeted SpO2 to a lower (85%–89%) or higher (91%–95%) range through 36 weeks’ postmenstrual age or off respiratory support.Main outcome measures Severe ROP defined as threshold ROP, ophthalmological surgery or bevacizumab treatment.Results There were statistically significant interactions between duration of oxygen supplementation and percentage of time in certain achieved saturation ranges. Specifically, for infants who spent at least 2 weeks on oxygen in postnatal weeks 1–5, a higher percentage of time at 91%–96% SpO2 was associated with increased odds of severe ROP. For infants who spent at least 3 weeks on oxygen in postnatal weeks 6–9, a higher percentage of time at 97%–100% SpO2 was associated with increased odds of severe ROP. Other significant risk factors were lower gestational age and birth weight, non-Hispanic white versus black race, prospectively defined severe illness, late-onset sepsis or meningitis, and clinical centre.Conclusions Among extremely preterm survivors to discharge, the association between SpO2 and severe ROP depended on the timing and duration of oxygen supplementation.