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Blood Gases and Retinopathy of Prematurity: The ELGAN StudyHauspurg A.K.a · Allred E.N.b–d · Vanderveen D.K.e, f · Chen M.g · Bednarek F.J.h · Cole C.i · Ehrenkranz R.A.a, j · Leviton A.b, c · Dammann O.b, g, k
aYale University School of Medicine, New Haven, Conn., bNeuroepidemiology Unit, Children’s Hospital Boston, cNeurology, Harvard Medical School, dBiostatistics, Harvard School of Public Health, eDepartment of Ophthalmology, Children’s Hospital Boston, fHarvard Medical School, and gDivision of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Mass., hDivision of Neonatology, Department of Pediatrics, UMass Memorial, Worcester, Mass., iDivision of Neonatology, Department of Pediatrics, Boston Medical Center, Boston, Mass., jDepartment of Pediatrics, Yale University School of Medicine, New Haven, Conn., USA; kPerinatal Neuroepidemiology Unit, Hannover Medical School, Hannover, Germany Corresponding Author
Prof. Olaf Dammann
Division of Newborn Medicine
Floating Hospital for Children at Tufts Medical Center
800 Washington St., Box 854, Boston, MA 02111 (USA)
Tel. +1 617 636 0240, Fax +1 617 636 3309, E-Mail email@example.com
Objective: This study tested the hypothesis that preterm infants who had a blood gas derangement on at least 2 of the first 3 postnatal days are at increased risk for more severe retinopathy of prematurity (ROP). Method: 1,042 infants born before 28 weeks’ gestational age (GA) were included. An infant was considered to be exposed if his/her blood gas measure was in the highest or lowest quartile for GA on at least 2 of the first 3 postnatal days. Results: Multivariable models adjusting for confounders indicate that exposure to a PCO2 in the highest quartile predicts ROP (stage 3, 4 or 5: OR = 1.6, 95% CI = 1.1–2.3); zone 1: 2.0, 1.1–3.6; prethreshold/threshold: 1.9, 1.2–3.0; plus disease: 1.8, 1.1–2.9). Estimates are similar for a low pH for zone 1 (2.1, 1.2–3.8), prethreshold/threshold (1.8, 1.1–2.8), but did not quite achieve statistical significance for ROP stage 3, 4, or 5 (1.4, 0.9–2.0) and plus disease (1.5, 0.9–2.4). A PaO2 in the highest quartile for GA on at least 2 of the first 3 postnatal days was associated with a doubling of the risk of ROP in zone 1 (2.5, 1.4–4.4) and of prethreshold/threshold disease (2.1, 1.4–3.3), a 70% risk increase for plus disease (1.7, 1.04–2.8), while a 40% risk increase for ROP stage 3 or higher did not achieve statistical significance (1.4, 0.96–2.0). Conclusion: Infants exposed to high PCO2, low pH and high PaO2 appear to be at increased risk of more severe ROP.
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