June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Effects of Fetal Hemoglobin on Systemic Oxygenation in Preterm Infants and the Development of Retinopathy of Prematurity
Author Affiliations & Notes
  • kim jiramongkolchai
    Retina, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • michael x repka
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Jing Tian
    Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Susan Aucott
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Jennifer Shepard
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Megan E Collins
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Julia Clemens
    University of Vermont College of Medicine, Burlington, Vermont, United States
  • Mia Feller
    Georgetown University Medical Center, Washington, District of Columbia, United States
  • Yesha Shah
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • irina burd
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Marina Roizenblatt
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Kerry Smith
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • J Fernando Arevalo
    Retina, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Peter L Gehlbach
    Retina, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • James T Handa
    Retina, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   kim jiramongkolchai, None; michael repka, None; Jing Tian, None; Susan Aucott, None; Jennifer Shepard, None; Megan Collins, None; Julia Clemens, None; Mia Feller, None; Yesha Shah, None; irina burd, None; Marina Roizenblatt, None; Kerry Smith, None; J Fernando Arevalo, None; Peter Gehlbach, None; James Handa, None
  • Footnotes
    Support  knights templar eye foundation career starter award
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3268. doi:
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      kim jiramongkolchai, michael x repka, Jing Tian, Susan Aucott, Jennifer Shepard, Megan E Collins, Julia Clemens, Mia Feller, Yesha Shah, irina burd, Marina Roizenblatt, Kerry Smith, J Fernando Arevalo, Peter L Gehlbach, James T Handa; Effects of Fetal Hemoglobin on Systemic Oxygenation in Preterm Infants and the Development of Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3268.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine fetal hemoglobin levels on systemic oxygenation and development of retionopathy of prematurity (ROP) in preterm infants.

Methods : A prospective study of preterm infants (born < 31 weeks gestational age or <1500 g) with HbF measured at birth (cord blood), 31-, 34-, and 37-weeks post-menstrual age (PMA), complete blood gas and SpO2 recorded up to 42-weeks PMA, and at least one ROP exam.

Results : From September 1, 2017 through December 31, 2018, 64 preterm infants were enrolled; 3 patients were excluded due to incomplete hemoglobin studies and 1 patient was withdrawn by their parent from the study prior to the first blood sample. Higher HbF was associated with significantly higher SpO2, lower PCO2 , lower FiO2 from birth to 31 weeks PMA and 31 to 34 weeks PMA (rs=0.51, rs=-0.62, and rs =-0.63; p<0.0001 and rs =0.71, rs =-0.58, and rs =-0.79; p<0.0001, respectively). To maintain oxygen saturation goals set by the neonatal intensive care unit, higher median FiO2 was required for HbF in the lowest tercile from birth compared to HbF in the highest tercile to 31 weeks and 31 to 34 weeks PMA; FiO2=35 (21-100) vs 21 (21-30) p<0.006 and FiO2=30 (28-100) vs 21 (21-30); p<0.001, respectively. Preterm infants with ROP had poorer indices of systemic oxygenation, as measured by median levels of SpO2 and PCO2, and lower levels of HbF (p<0.039 and p<0.0001, respectively) up to 34 weeks PMA).

Conclusions : Low HbF levels correlated with poor oxygenation indices in the preterm infant and were associated with an increased risk for developing ROP. These results show that HbF levels influence systemic oxygenation. Thus, oxygen therapy may need titration that is based on HbF levels to reduce the risk of ROP development.

This is a 2021 ARVO Annual Meeting abstract.

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