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Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity.

Journal article
Authors Pia Lundgren
Anna-Lena Hård
Åsa Wilde
Chatarina Löfqvist
Lois E.H. Smith
Ann Hellström
Published in Acta Paediatrica, International Journal of Paediatrics
Volume 107
Issue 5
ISSN 0803-5253
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Language en
Links doi.org/10.1111/apa.14049
Keywords Oxygen saturation, Poor weight gain, Preterm birth retinopathy of prematurity, Risk factors
Subject categories Ophthalmology

Abstract

©2017 Foundation Acta Pædiatrica. Aim: This study evaluated poor weight gain as a risk factor for infants who required treatment for retinopathy of prematurity (ROP), by comparing those born before and after the implementation of higher oxygen saturation (SpO 2 ) targets at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Methods: We compared infants born at less than 31 weeks, who were screened and, or, treated for ROP: 127 in 2011-2012 when SpO 2 targets were 88-92% and 142 in 2015-2016 when they were 91-95%. The subjects were reviewed for birth characteristics, weekly weight and ROP treatment. Data were analysed using the weight, insulin-like growth factor 1, neonatal, ROP (WINROP) prediction tool. Results: The 2011-2012 infants who needed ROP treatment (12.6%) had significantly poorer postnatal weight gain than those who did not, but this was not seen in the treated (17.6%) and nontreated ROP groups in 2015-2016. WINROP sensitivity decreased from 87.5% in 2011-12 to 48% in 2015-2016. Conclusion: After the SpO 2 target range was increased from 88-92% to 91-95%, postnatal weight gain was no longer a significant risk factor and WINROP lost its ability to predict ROP requiring treatment. Risk factors clearly change as neonatal care develops.

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