Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Arterial Oxygen Fluctuation and Retinopathy of Prematurity in Very-Low-Birth-Weight Infants

Journal of Perinatology volume 24, pages 82–87 (2004)Cite this article

Abstract

OBJECTIVE: To determine the influence of arterial oxygen fluctuation on development of threshold ROP.

STUDY DESIGN: Retrospective study of 231 infants, ≤1500 g birth weight, who were admitted to Arkansas Children's Hospital NICU from January 1993 to June 1995. Fluctuation in partial pressure of dissolved arterial oxygen (PaO2) was expressed as coefficient of variation (CoV) for each infant. We investigated the relationship between CoV at three intervals and the risk of developing threshold ROP.

RESULTS: The odds ratio (OR) of developing threshold ROP versus prethreshold ROP or less associated with a 10% increase in the CoV during the first 5 days of oxygen therapy was 1.44, and during the first 10 days was 1.51. When analysis was restricted to infants receiving 30 days of therapy, the OR during the first 5 days of therapy was 1.67, during the first 10 days was 1.82, and during days 11–30 was 1.68.

CONCLUSIONS: Very-low-birth-weight infants experiencing fluctuating PaO2 are at higher risk of threshold ROP.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. The STOP-ROP Multicenter Study Group. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics 2000;105 (2):295–310.

  2. Payne JW, Patz A . Current status of retrolental fibroplasias. Ann Clin Res 1979;11:205–211.

    CAS  PubMed  Google Scholar 

  3. Schaffer DB, Palmer EA, Plotsky DF et al. Prognostic factors in the natural course of retinopathy of Prematurity. Ophthalmology 1993;100:230.

    Article  CAS  Google Scholar 

  4. Kalina RE, Karr DJ . Retrolental fibroplasia: experience over two decades in one institution. Ophthalmology 1982;89:91–95.

    Article  CAS  Google Scholar 

  5. Kinsey VE, Arnold JH, Kalina RE, et al. PO2 levels and retrolental fibroplasia: a report of the cooperative study. Pediatrics 1977;60:655–668.

    CAS  Google Scholar 

  6. Majima A . Studies on retinopathy of prematurity. I. Statistical analysis of factors related to occurrence and regression in active phase. Jpn J Ophthalmol 1977;21:404–420.

    Google Scholar 

  7. Quinn G . Retinal Development and the Pathophysiology of Retinopathy of Prematurity, Polin and Fox Fetal and Neonatal Physiology. Vol. 2. London: Saunders; 1998. p.2252.

    Google Scholar 

  8. Weiter JJ, Zuckerman R, Schepens CL . A model for the pathogenesis of retrolental fibroplasia based on the metabolic control of blood vessel development. Ophthalmic Surg 1982;13:1013–1017.

    CAS  PubMed  Google Scholar 

  9. Nelson L . Disorders of the Eye, Nelson Textbook of Pediatrics. Vol. 15. London: Saunders; 1996. p.1790.

    Google Scholar 

  10. Foos RY . Chronic retinopathy of prematurity. Ophthalmology 1985;92:573–574.

    Article  Google Scholar 

  11. Kinsey VE, Jacobus JT, Hemphill F . Retrolental fibroplasia: cooperative study of retrolental fibroplasia and the use of oxygen. Arch Ophthalmol 1956;56:481–547.

    Article  CAS  Google Scholar 

  12. Weakley DR, Spencer R . Current concepts in retinopathy of prematurity. Early Hum Develop 1992;30:121–138.

    Article  Google Scholar 

  13. Biglan A, Brown D, Reynolds J, Milley R . Risk factors associated with retrolental fibroplasia. Ophthalmology 1984;91:1504–1511.

    Article  CAS  Google Scholar 

  14. Brown BA, Thach AB, Song JC, Marx JL, Kwun RC, Frambach DA . Retinopathy of prematurity: evaluation of risk factors. Int Ophthalmol 1998;22 (5):279–283.

    Article  Google Scholar 

  15. Gunn TR, Easdown J, Outerbride EW, Aranda JV . Risk factors in retrolental fibroplasia. Pediatrics 1980;65:1096–1100.

    CAS  PubMed  Google Scholar 

  16. Holmstrom G . Retinopathy of prematurity. BMJ 1993;307 (6906):694–695.

    Article  CAS  Google Scholar 

  17. Hammer ME, Mullen PW, Ferguson JG, Pai S, Cosby C, Jackson KL . Logistic analysis of risk factors in acute retinopathy of prematurity. Am J Ophthalmol 1986;102:1–6.

    Article  CAS  Google Scholar 

  18. Purohit DM, Ellison RC, Zierler S, Miettinen OS, Nadas AS . Risk factors for retrolental fibroplasia: experience with 3025 premature infants. Pediatrics 1985;76:339–344.

    CAS  PubMed  Google Scholar 

  19. Schaffer D, Palmer E, Plotsky D, et al. Prognostic factors in the natural course of retinopathy of prematurity. Ophthalmology 1993;100:230–237.

    Article  CAS  Google Scholar 

  20. Cunningham S, Fleck BW, Elton RA, McIntosh N . Transcutaneous oxygen levels in retinopathy of prematurity. Lancet 1995;346 (8988):1464–1465.

    Article  CAS  Google Scholar 

  21. Gaynon M, Stevenson D . What can we learn from STOP-ROP and earlier studies? Pediatrics 2000;105 (2):420–422.

    Article  CAS  Google Scholar 

  22. Saito Y, Omoto T, Cho Y, Hatsukawa Y, Fujimura M, Takeuchi T . The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefe's Arch Clin Exp Ophthalmol 1993;231:151–156.

    Article  CAS  Google Scholar 

  23. Penn JS, Henry MM, Tolman BL . Exposure to alternating hypoxia and hyperoxia causes severe proliferative retinopathy in the newborn rat. Pediatr Res 1994;36 (6):724–731.

    Article  CAS  Google Scholar 

  24. Penn JS, Henry MM, Wall PT, Tolman BL . The range of PaO2 variation determines the severity of oxygen-induced retinopathy in newborn rats. Invest Ophthalmol Vis Sci 1995;36 (10):2063–2070.

    CAS  PubMed  Google Scholar 

  25. Penn JS, Tolman BL, Lowery LA . Variable oxygen exposure causes preretinal neovascularization in the newborn rat. Invest Ophthalmol Vis Sci 1993;34 (3):576–585.

    CAS  PubMed  Google Scholar 

  26. Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. Arch Ophthalmol 1984;102:1130–1134.

  27. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multi-center trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol 1988;106:471–479.

  28. Zar JH . Biostatistical Analysis. Englewood, NJ: Prentice-Hall, Inc.; 1974. p. 34.

    Google Scholar 

  29. SAS Institute. SAS System for Windows. Cary, NC: SAS Institute; 1996.

  30. Curley MA, Thompson JE, Arnold JH . The effects of early and repeated prone positioning in pediatric patients with acute lung injury. Chest 2000;118 (1):156–163.

    Article  CAS  Google Scholar 

  31. Calkovska A, Sun B, Curstedt T, Renheim G, Robertson B . Combined effects of high-frequency ventilation and surfactant treatment in experimental meconium aspiration syndrome. Acta Anaesthesiol Scan 1999;43 (2):135–145.

    Article  CAS  Google Scholar 

  32. Tang SF, Sherwood MC, Miller OI . Randomized trial of three doses of inhaled nitric oxide in acute respiratory distress syndrome. Arch Dis Child 1998;79 (5):415–418.

    Article  CAS  Google Scholar 

  33. Zobel G, Urlesberger B, Dacar D, Rodl S, Reiterer F, Friehs I . Partial liquid ventilation combined with inhaled nitric oxide in acute respiratory failure with pulmonary hypertension in piglets. Pediatr Res 1997;41 (2):172–177.

    Article  CAS  Google Scholar 

  34. Katzman G, Sarish M, Krishnan V . Hypoxemia and retinopathy of prematurity. Pediatrics 1987;80:972.

    CAS  PubMed  Google Scholar 

  35. Wolbarsht ML, George GS, Shearin Jr WA, Kylstra JA, Landers MB . Retinopathy of prematurity: a new look at an old disease. Ophthalmic Surg 1983;14 (11):919–924.

    CAS  PubMed  Google Scholar 

  36. Flynn J, Bancalari E, Snyder ES, et al. A cohort study of transcutaneous oxygen tension and the incidence and severity of retinopathy of prematurity. N Engl J Med 1992;326 (16):1050–1054.

    Article  CAS  Google Scholar 

  37. Palmer EA, Flynn J, Hardy RJ, et al. Incidence and early course of retinopathy of prematurity. Ophthalmology 1991;998:1628–1640.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neonatology, Vanderbilt University, Nashville, TN, USA

    Jackie R York MD

  2. Department of Neonatology, Seton Medical Center, Austin, TX, USA

    Susan Landers MD

  3. Maternal and Child Health, Birmingham, AL, USA

    Russell S Kirby PhD

  4. Division of Biostatistics, Department of Preventive Medicine, Vanderbilt University, Nashville, TN, USA

    Patrick G Arbogast PhD

  5. Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, TN, USA

    John S Penn PhD

Authors
  1. Jackie R York MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan Landers MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Russell S Kirby PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patrick G Arbogast PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John S Penn PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

New Address of JRY: Johnson City Medical Center, 400 N State of Franklin Road, Johnson City, TN 37604-6094, USA.

This work was supported by NIH EY07533 to John S. Penn, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

York, J., Landers, S., Kirby, R. et al. Arterial Oxygen Fluctuation and Retinopathy of Prematurity in Very-Low-Birth-Weight Infants. J Perinatol 24, 82–87 (2004). https://doi.org/10.1038/sj.jp.7211040

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211040

This article is cited by

Search

Advanced search

Quick links