Correlation of Retinopathy of Prematurity with Oxygen Saturation

Retinopathy of prematurity (ROP) is an abnormal vascular proliferative disease of retina that affects preterm infants. It is a leading cause of childhood blindness worldwide despite improvement in neonatal care and management. Earlier ROP was found to be associated with oxygen therapy only. Now it was concluded that aetiology of ROP was multifactorial but three factors have shown significant association with ROP: low gestational age (GA), low birth weight (BW), prolonged exposure to supplementary oxygen following delivery. Several investigators reported that lower oxygen saturation targets at young post-gestational ages with increased oxygen saturation targets at older post gestational ages reduced the incidence of ROP. However previous clinical studies are not conclusive.

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Prevalence and Risk Factors For Retinopathy of Prematurity Among Infants in Minilk-II Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study, 2020.

10.21203/rs.3.rs-148640/v1 ◽

2021 ◽

Author(s):

Emebet Berhane Woldemariam ◽

Hana Endale Aliyou ◽

Yosef Tsige Redi

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Medical Records ◽

Oxygen Therapy ◽

Maternal Education ◽

Cross Sectional ◽

Childhood Blindness ◽

Zone Ii ◽

The Impact

Abstract Background: Retinopathy of prematurity (ROP) is defined as a vaso-proliferative retinal disorder that leads to childhood blindness; and persists as the main cause of preventable childhood blindness. The impact of ROP in developing countries is heavier as term infants can develop ROP because of inadequate awareness of the disease development and the risk factors. Hence, the aim of the study is assessing the prevalence and risk factors for retinopathy of prematurity in the specific study area.Methodology: An institutional based cross-sectional retrospective study was conducted on 301 samples of the pediatrics out-patient eye clinic medical records, at Minilik II referral hospital, from March to April 2020. Study subjects were selected using systematic random sampling method. Data was collected from medical records of all infants visiting the hospital for eye problems from January 2018 to December 2019, using a structured check list. The collected data was entered and cleaned using Epi data 6.4.2.0 and then exported & analyzed using SPSS version 25. Bivariate and multivariate analysis was computed to distinguish the statistically significant factors. Result: The prevalence of ROP among infants in this study showed 39(13%). Of these, more than half (56.4%) were Zone II + Stage 1, followed by Zone II + stage-2, and Stage-5; 12.8% and 10.2% respectively. Birth weight, oxygen therapy and sepsis were the factors significantly associated with ROP [AOR= 39.28; 95% CI: 3.204- 481.658], [AOR= 5.317; 95% CI:1.009- 28.019] and [AOR=9.805; 95% CI:1.592- 60.388] respectively. Conclusions: the prevalence of ROP in the current study is (13%). Birth weight, oxygen therapy and sepsis were the determinant risk factors for development of ROP. Regular ANC, and maternal education may be important to reduce the risk of low-birth weight, and sepsis that results in long-term oxygen therapy leading to childhood blindness.

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Abstract 14185: Targeting Lower Oxygen Saturation Parameters in Premature Infants Does Not Increase Incidence of Pulmonary Hypertension in the Neonatal Intensive Care Unit

Circulation ◽

10.1161/circ.142.suppl_3.14185 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Maria Niccum ◽

Fotios Spyropoulos ◽

Jonathan Levin ◽

Carter Petty ◽

Mary P Mullen ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Logistic Regression ◽

Birth Weight ◽

Oxygen Saturation ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Positive Association ◽

Increased Risk ◽

Significant Difference ◽

Lower Oxygen

Introduction: Lower oxygen saturation targets in preterm infants have been associated with decreased incidence of bronchopulmonary dysplasia (BPD) but increased risk of pulmonary hypertension (PH). Studies have shown that targets of <90% are associated with higher incidence of PH, however data on the optimal saturation target >90% are lacking. In this study, we compared the rate of BPD and PH in two cohorts with saturation targets of 94-98% and 92-97%. We hypothesized that BPD rate would be lower and PH rate would be unchanged at the lower saturation target. Methods: We performed a retrospective cohort study comparing PH and BPD rates among two cohorts of infants born at ≤32 weeks gestation at Brigham and Women’s Hospital: cohort 1 with saturation target of 94-98% (n = 129, July 2017-July 2018), cohort 2 with saturation target of 92-97% (n = 124, July 2018-July 2019). PH was defined by echocardiographic evidence of systolic septal flattening or right ventricular pressure ≥35 mmHg (estimated by tricuspid regurgitant jet velocity or shunt velocity) at gestational age (GA) ≥36 weeks. Comparisons between groups were carried out by Chi-square test, t-test, and multivariable logistic regression. Results: Subjects had a GA of 23-32 weeks; 46% were female. Groups did not differ with respect to GA, sex, or birth weight. There was no difference in rate of PH (2.4% vs. 4.2%, p = 0.12) or BPD (25% vs. 20%, p = 0.31) between cohort 1 and cohort 2. Other clinical parameters were not different between groups, including presence of patent ductus arteriosus, presence of atrial septal defect, use of diuretics, or use of steroids. After controlling for GA, birth weight, sex, and diagnosis of BPD using logistic regression, there was no difference in rate of PH between groups (p = 0.47), but there was a positive association of BPD with PH (OR 3.45; 95% CI, 1.18-10.09; p = 0.02). Conclusions: A lower oxygen saturation target was not associated with a higher rate of PH or lower rate of BPD in preterm infants. The overall rate of PH was much lower than rates previously reported at saturation targets <90%. Given our low incidence of PH, and the lack of a significant difference in rate of PH between groups, a saturation target of 92-97% may be safe while also minimizing need for supplemental oxygen in this population.

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Lower oxygen saturation targets in preterm infants are not associated with increased rates of pulmonary hypertension

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200637 ◽

2021 ◽

pp. 1-8

Author(s):

M. Niccum ◽

F. Spyropoulos ◽

J.C. Levin ◽

C.R. Petty ◽

M.P. Mullen ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Birth Weight ◽

Oxygen Saturation ◽

Preterm Infants ◽

Gestational Age ◽

Retrospective Cohort ◽

Chi Square ◽

Average Birth Weight ◽

Lower Oxygen ◽

Chi Square Test

BACKGROUND: The optimal oxygen saturation target in preterm infants is not known. In this study, we aimed to assess the effect of lower oxygen saturation targets on the rate of bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and pulmonary hypertension (PH) in preterm infants. METHODS: Retrospective cohort study comparing BPD, ROP, and PH incidence among two cohorts of infants born at≤32 weeks gestation with different oxygen saturation targets at≥34 weeks post-menstrual age (PMA): cohort 1, 94–98% (n = 126); cohort 2, 92–97% (n = 121). Groups compared by Chi-square test, t-test, and multivariable logistic regression. RESULTS: When comparing cohort 1 (average gestational age 29.8 weeks, average birth weight 1271g) with cohort 2 (average gestational age 29.6 weeks, average birth weight 1299g), there was no difference in rate of BPD (24% vs. 19%, p = 0.38), ROP (4% vs. 3%, p = 0.49), or PH (2% vs. 4%, p = 0.44). CONCLUSION: An oxygen saturation target of 92–97% at≥34 weeks PMA was not associated with a higher rate of PH or lower rate of BPD or ROP when compared with a higher target of 94–98%.

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Reduced rate of treated retinopathy of prematurity after implementing lower oxygen saturation targets

Journal of Perinatology ◽

10.1038/s41372-018-0300-y ◽

2019 ◽

Vol 39 (3) ◽

pp. 409-414 ◽

Cited By ~ 1

Author(s):

Fanny Söderström ◽

Erik Normann ◽

Gerd Holmström ◽

Eva Larsson ◽

Fredrik Ahlsson ◽

...

Keyword(s):

Oxygen Saturation ◽

Retinopathy Of Prematurity ◽

Lower Oxygen ◽

Reduced Rate

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Retinopathy of Prematurity in Neonates and its Risk Factors: A Seven Year Study in Northern Iran

The Open Ophthalmology Journal ◽

10.2174/1874364101610010017 ◽

2016 ◽

Vol 10 (1) ◽

pp. 17-21 ◽

Cited By ~ 4

Author(s):

Seyed Ahmad Rasoulinejad ◽

Mohammad Montazeri

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Multiple Gestation ◽

Northern Iran ◽

Cross Sectional ◽

Ophthalmologic Examination ◽

High Index Of Suspicion

Purpose: An important cause of avoidable childhood blindness is retinopathy of prematurity (ROP) in countries with high human development index and also in some emerging economies countries. To date, no research have been conducted on analyzing data of ROP prevalence in Babol, and this is the first research performed on ROP in this area. Methods: All VLBW babies who referred to Babol ophthalmology center over the seven years, from February 2007 to December 2013 were enrolled in this descriptive cross-sectional research. A team of researchers recorded patients’ information completely in check lists. A single experienced ophthalmologist performed ophthalmologic examination of patients. Result: The incidence of ROP of any stage in Babol was determined to be 306 (45%) of all babies enrolled in this study. In present study, key risk factors of ROP were low gestational age, oxygen therapy more than five days and low birth weight. Conclusion: The findings of current study demonstrate that the main risk factors of developing ROP in newborns are multiple gestation, low birth weight, oxygen therapy for more than five day. Therefore, the progression of ROP to blindness will be prevented by a high index of suspicion, suitable screening, prompt diagnosis, and early treatment.

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Validation of ROPScore to predict retinopathy of prematurity among very low birth weight preterm infants in a southern Brazilian population

Arquivos Brasileiros de Oftalmologia ◽

10.5935/0004-2749.20190093 ◽

2019 ◽

Vol 82 (6) ◽

Author(s):

Patricia Zanotelli Cagliari ◽

Vanessa Carvalho Lucas ◽

Isabela Carolina Borba ◽

Danieli Mayumi Kimura Leandro ◽

Carmem Luiza Gascho ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Brazilian Population

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Time to regain birth weight - a marker to predict the severity of retinopathy of prematurity?

BMC Pediatrics ◽

10.1186/s12887-021-03027-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ajay Anvekar ◽

Sam Athikarisamy ◽

Shripada Rao ◽

Andy Gill ◽

Elizabeth Nathan ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Control Groups ◽

Gestational Age At Birth ◽

And Control ◽

Type 1 Rop ◽

Age At Birth

Abstract Background Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight (BW) be used as an additional marker to identify infants with type 1 ROP. Methods In this retrospective study, preterm infants (< 27 weeks gestational age at birth) born during the period from 1/1/2010–31/12/2015 at a tertiary neonatal intensive care unit in Australia were included. Twenty-seven preterm infants with Type 1 ROP were identified. Controls (No ROP or ROP other than type 1) were matched with cases on gestational age at birth and BW (1:4 ratio). Data were collected from the database and medical records. Results The median (IQR) gestational age for Type 1 ROP and control groups were 24 (24–26) and 25 (24–26) weeks respectively and median (IQR) BW for Type 1 ROP and control groups were 675 (635–810) and 773 (666–884) grams respectively. Preterm infants with Type 1 ROP were more likely to be small for gestational age (SGA) (18.5% vs 3.7%, p = 0.015) and had increased weeks on oxygen therapy (median 11.9 vs 9.1, p = 0.028). Time to regain BW was longer in preterm infants with type 1 ROP than controls but did not reach statistical significance (median 9 vs 7 days, OR 1.08, 95% CI 1.00–1.17, p = 0.059) adjusted for SGA and duration of oxygen therapy. The area under the curve from the time to regain BW model with adjustment for SGA and duration of oxygen therapy was 0.73 (95% CI 0.62–0.83). Conclusion We hypothesize that time to regain BW has potential to aid prediction of Type 1 ROP and this warrants further investigation in a larger prospective study.

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Differential Diagnosis of Retinopathy of Prematurity

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0072 ◽

2018 ◽

pp. 73-77

Keyword(s):

Differential Diagnosis ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Incontinentia Pigmenti ◽

Normal Birth Weight ◽

Childhood Blindness ◽

Norrie Disease ◽

Normal Birth ◽

Preterm Babies ◽

Retinal Pathologies

Retinopathy of prematurity (ROP) which is a proliferative vitreoretinopathy is seen in preterm babies has become one of the main causes of preventable childhood blindness in the developing countries. Nowadays, the survival rate of preterm babies who have low birth weight has been increasing thanks to neonatal advances. For this reason, the incidence of ROP has increased in recent times. Similar retinal pathologies to ROP can be seen in the term babies with normal birth weight. In this review, it is aimed to be discussed in detail on the retinal vascular disorders that may be mistaken with ROP clinically such as familial exudative vitreoretinopathy, persistent fetal vasculopathy, Norrie disease, incontinentia pigmenti, and osteoporosis pseudoglioma.

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Validation of The DIGIROP-Birth Model in A Chinese Cohort

10.21203/rs.3.rs-155459/v1 ◽

2021 ◽

Author(s):

Sizhe Chen ◽

Rong Wu ◽

He Chen ◽

Wenbei Ma ◽

Shaolin Du ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Receiver Operating Characteristic ◽

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Roc Curve ◽

Operating Characteristic ◽

Predictive Performance ◽

Postnatal Risk Factors

Abstract Background We aimed to validate the predictive performance of the DIGIROP-Birth model for identifying treatment-requiring retinopathy of prematurity (TR-ROP) in Chinese preterm infants to evaluate its generalizability across countries and races. Methods We retrospectively reviewed the medical records of preterm infants who were screened for retinopathy of prematurity (ROP) in a single Chinese hospital between June 2015 and August 2020. The predictive performance of the model for TR-ROP was assessed through the construction of a receiver-operating characteristic (ROC) curve and calculating the areas under the ROC curve (AUC), sensitivity, specificity, and positive and negative predictive values. Results Four hundred and forty-two infants (mean (SD) gestational age = 28.8 (1.3) weeks; mean (SD) birth weight = 1237.0 (236.9) g; 64.7% males) were included in the study. Analyses showed that the DIGIROP-Birth model demonstrated less satisfactory performance than previously reported in identifying infants with TR-ROP, with an area under the receiver-operating characteristic curve of 0.634 (95% confidence interval = 0.564–0.705). With a cutoff value of 0.0084, the DIGIROP-Birth model showed a sensitivity of 48/93 (51.6%), which increased to 89/93 (95.7%) after modification with the addition of postnatal risk factors. In infants with a gestational age < 28 weeks or birth weight < 1000 g, the DIGIROP-Birth model exhibited sensitivities of 36/39 (92.3%) and 20/23 (87.0%), respectively. Conclusions Although the predictive performance was less satisfactory in China than in developed countries, modification of the DIGIROP-Birth model with postnatal risk factors shows promise in improving its efficacy for TR-ROP. The model may also be effective in infants with a younger gestational age or with an extremely low birth weight.

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