Elsevier

The Journal of Pediatrics

Volume 168, January 2016, Pages 242-244
The Journal of Pediatrics

Clinical and Laboratory Observations
Higher Rates of Retinopathy of Prematurity after Increasing Oxygen Saturation Targets for Very Preterm Infants: Experience in a Single Center

https://doi.org/10.1016/j.jpeds.2015.10.005Get rights and content

Randomized trials of oxygen saturation target ranges for extremely preterm infants showed increased survival but increased retinopathy of prematurity with higher compared with lower target ranges. In our center, changing from a target range of 88%-92% to 91%-95% has been associated with increased rates and severity of retinopathy of prematurity.

Section snippets

Methods

We retrospectively audited rates of ROP from our neonatal unit database, which records demographic and clinical information, whether infants were screened for ROP, the stage of any ROP present, and whether laser surgery for ROP was performed. In our center, infants are eligible for ROP screening if they were <30 weeks GA or weighed <1250 g at birth, and are alive from 30 weeks post-menstrual age onwards. Screening commences between 30 to 32 weeks GA, and examinations are repeated every

Results

A total of 346 infants met birth weight or GA criteria for eye examination during the study period: 151 in the before cohort and 195 in the after cohort. Table I shows the demographics of the groups. There were no differences in GA, birth weight, or sex. Infants in the after cohort were more often exposed to antenatal corticosteroids (94% vs 83%, P = .001), and survivors had a longer duration of respiratory support (median 11 vs 6 days, P = .029), but there was no difference in rate of

Discussion

In our center, a change to a higher oxygen saturation target range for preterm infants from 88%-92% to 91%-95% has been associated with an increased rate and severity of ROP, particularly amongst extremely preterm infants. Although the increase in ROP is not unexpected, it has occurred despite a more modest change in saturation targets than studied in the randomized trials. The number needed to harm (NNH) for stage III or worse ROP in extremely preterm infants in our study was 25, consistent

References (3)

  • W.A. Carlo et al.

    Target ranges of oxygen saturation in extremely preterm infants

    N Engl J Med

    (2010)
There are more references available in the full text version of this article.

Cited by (0)

The authors declare no conflicts of interest.

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