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.
© 2010 S. Karger AG, Basel
- Retinopathy of prematurity
- Extremely low gestational age
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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 firstname.lastname@example.org
A.L. and O.D. contributed equally to this work.
Received: January 25, 2010
Accepted after revision: March 24, 2010
Published online: July 30, 2010
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 4, Number of References : 45
Neonatology (Fetal and Neonatal Research)
Vol. 99, No. 2, Year 2011 (Cover Date: February 2011)
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