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Xochitl Mellor, Marcela Estrada, Lauren Tomlinson, Yinxi Yu, Gui-Shuang Ying, Gil Binenbaum; Daily oxygen supplementation and risk of retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2194.
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© ARVO (1962-2015); The Authors (2016-present)
Although higher blood oxygen saturation levels increase the risk of severe retinopathy of prematurity (ROP), complicated measures of respiratory status are impractical as screening criteria. We sought to determine if a simple, clinically useful measure of ROP risk can be developed using degree or duration of oxygen supplementation during the first month of postnatal life.
North American infants from the G-ROP-1 (29 hospitals, 2006-2012) and G-ROP-2 (41 hospitals, 2015-2017) studies with complete daily supplemental (>21%) oxygen data were studied. Associations between severe ROP and days on supplemental oxygen (DSO) during ages 0-28 days were assessed using multivariable regression, controlling for BW, GA, and other factors. Multiple screening criteria were compared: newly developed criteria incorporating DSO; G-ROP criteria, which include slow weight gain measures; G-ROP updated with DSO; and current guidelines.
8,949 infants (5,886 G-ROP-1, 3,063 G-ROP-2) were studied. 459 (5.1%) developed Type 1, 523 (5.8%) were treated. DSO during ages 0-28 days was associated with severe ROP overall (aOR 1.174 per day increase, 95%CI 1.158-1.190). The following criteria had 100% sensitivity for Type 1 and higher specificity than current guidelines: New criteria with DSO (BW<901g, GA<26 weeks, DSO>3) had 23% fewer infants examined; modified G-ROP including DSO, 29% fewer; original G-ROP, 32% fewer.
A simple DSO measure improves specificity but is still not as specific as the G-ROP criteria. In high-level-neonatal-care settings, incorporating simple measures of oxygen supplementation into screening criteria does not improve ROP prediction more than postnatal weight gain.
This is a 2020 ARVO Annual Meeting abstract.
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