Effect of fluctuation of oxygenation on the development of severe retinopathy of prematurity in extremely preterm infants

Objective To investigate factors associated with development of severe retinopathy of prematurity (ROP) in extremely preterm (EP) infants. Study design This retrospective cohort study included 213 EP infants (22 + 0 to 27 + 6 weeks gestation) who were admitted to the neonatal intensive care unit of Osaka Women's and Children's Hospital between 2009 and 2017. Multivariable logistic regression analysis was used to identify neonatal factors associated with severe ROP requiring treatment. Result After adjustments for gestational age (GA), birth weight, sex, red blood cell transfusion, average SpO(2), and fluctuations of SpO(2) from birth to 32 weeks postmenstrual age, fluctuations of SpO(2) (odds ratio [OR]: 2.10, 95% confidence interval [CI]: 1.03-4.27), and low GA (OR: 0.95, 95% CI: 0.91-0.98) were significantly associated with severe ROP. Conclusions Fluctuations of SpO(2) from birth to 32 weeks postmenstrual age and low GA were significantly associated with development of severe ROP requiring treatment in EP infants.