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
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
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.
Payne JW, Patz A . Current status of retrolental fibroplasias. Ann Clin Res 1979;11:205–211.
Schaffer DB, Palmer EA, Plotsky DF et al. Prognostic factors in the natural course of retinopathy of Prematurity. Ophthalmology 1993;100:230.
Kalina RE, Karr DJ . Retrolental fibroplasia: experience over two decades in one institution. Ophthalmology 1982;89:91–95.
Kinsey VE, Arnold JH, Kalina RE, et al. PO2 levels and retrolental fibroplasia: a report of the cooperative study. Pediatrics 1977;60:655–668.
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.
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.
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.
Nelson L . Disorders of the Eye, Nelson Textbook of Pediatrics. Vol. 15. London: Saunders; 1996. p.1790.
Foos RY . Chronic retinopathy of prematurity. Ophthalmology 1985;92:573–574.
Kinsey VE, Jacobus JT, Hemphill F . Retrolental fibroplasia: cooperative study of retrolental fibroplasia and the use of oxygen. Arch Ophthalmol 1956;56:481–547.
Weakley DR, Spencer R . Current concepts in retinopathy of prematurity. Early Hum Develop 1992;30:121–138.
Biglan A, Brown D, Reynolds J, Milley R . Risk factors associated with retrolental fibroplasia. Ophthalmology 1984;91:1504–1511.
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.
Gunn TR, Easdown J, Outerbride EW, Aranda JV . Risk factors in retrolental fibroplasia. Pediatrics 1980;65:1096–1100.
Holmstrom G . Retinopathy of prematurity. BMJ 1993;307 (6906):694–695.
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.
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.
Schaffer D, Palmer E, Plotsky D, et al. Prognostic factors in the natural course of retinopathy of prematurity. Ophthalmology 1993;100:230–237.
Cunningham S, Fleck BW, Elton RA, McIntosh N . Transcutaneous oxygen levels in retinopathy of prematurity. Lancet 1995;346 (8988):1464–1465.
Gaynon M, Stevenson D . What can we learn from STOP-ROP and earlier studies? Pediatrics 2000;105 (2):420–422.
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.
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.
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.
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.
Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. Arch Ophthalmol 1984;102:1130–1134.
Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multi-center trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol 1988;106:471–479.
Zar JH . Biostatistical Analysis. Englewood, NJ: Prentice-Hall, Inc.; 1974. p. 34.
SAS Institute. SAS System for Windows. Cary, NC: SAS Institute; 1996.
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.
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.
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.
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.
Katzman G, Sarish M, Krishnan V . Hypoxemia and retinopathy of prematurity. Pediatrics 1987;80:972.
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.
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.
Palmer EA, Flynn J, Hardy RJ, et al. Incidence and early course of retinopathy of prematurity. Ophthalmology 1991;998:1628–1640.
Author information
Authors and Affiliations
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
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
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211040
This article is cited by
-
Retinopathy of Prematurity in Very Low Birthweight Neonates of Gestation Less Than 32 weeks in Malaysia
Indian Journal of Pediatrics (2024)
-
Retinopathy of prematurity: contribution of inflammatory and genetic factors
Molecular and Cellular Biochemistry (2022)
-
Maternal smoking as an independent risk factor for the development of severe retinopathy of prematurity in very preterm infants
Eye (2021)
-
Cerebral oxygenation in preterm infants during maternal singing combined with skin-to-skin care
Pediatric Research (2021)
-
Effect of fluctuation of oxygenation on the development of severe retinopathy of prematurity in extremely preterm infants
Journal of Perinatology (2020)