The Impact of Intermittent Hypoxemia on Type 1 Retinopathy of Prematurity in Preterm Infants

Abstract

AbstractBackgroundIntermittent hypoxemia (IH) may influence retinopathy of prematurity (ROP) development in preterm infants, however, previous studies had mixed results. This study aims to assess the influence and evaluate the predictive ability of IH measures on Type 1 ROP, a stage beyond which ROP treatment is indicated.MethodsIH was quantified by continuously monitoring oxygen saturation (SpO2) using high-resolution pulse oximeters during the first 10 weeks of life. Statistical analyses assessed the relationship and predictive ability of weekly and cumulative IH variables for Type 1 ROP development.ResultsUnivariate analyses suggested that IH measures are greater in infants with Type 1 ROP and are predictive of Type 1 ROP development. Multivariable logistic regression analyses revealed that cumulative IH of longer duration during certain postnatal periods are associated with Type 1 ROP development after adjusting for gestational age (GA) or birth weight (BW). Although area under the curve (AUC) analyses revealed added predictivity of cumulative IH variables above GA or BW, these increments in AUC were not statistically significant.ConclusionsThe duration of IH events was associated with Type 1 ROP development. Interventions for reducing the duration of IH events may potentially improve ROP outcomes.ImpactThis study investigates the impact of IH on the development of Type 1 ROP in preterm infants.Univariate analyses revealed that IH measures are greater in infants with Type 1 ROP and are predictive of Type 1 ROP development.Multivariable logistic regression analyses revealed that cumulative IH events of longer duration are associated with Type 1 ROP development after adjusting for GA or BW.Interventions for reducing the duration of IH events during critical postnatal periods may potentially improve ROP outcomes.