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Reduced rate of treated retinopathy of prematurity after implementing lower oxygen saturation targets

Journal of Perinatology volume 39, pages 409–414 (2019)Cite this article

Subjects

Abstract

Objective

To evaluate an implementation of lower oxygen saturation targets with retinopathy of prematurity (ROP) as primary outcome, in infants at the lowest extreme of prematurity.

Study design

Retrospective cohort including infants born at 22–25 weeks of gestation in 2005–2015 (n = 325), comparing high (87–93%) and low (85–90%) targets; infants transferred early were excluded from the main analysis to avoid bias.

Results

Overall survival was 76% in high saturation era, and 69% in low saturation era (p = .17). Treatment-requiring ROP was less common in low saturation group (14% vs 28%, p < .05) with the most prominent difference in the most immature infants. Including deceased infants in the analysis, necrotizing enterocolitis was more frequent in low saturation era (21% vs 10%, p < .05).

Conclusions

Implementing lower saturation targets resulted in a halved incidence of treatment-requiring ROP; the most immature infants seem to benefit the most. An association between lower oxygenation and necrotizing enterocolitis cannot be excluded.

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Acknowledgements

Funding

This study was supported by Födelsefonden and Gillbergska stiftelsen.

Author contributions

FS contributed to study design and conceptualization, is responsible for data collection, contributed to data analysis and interpretation, and drafted, reviewed, and revised the manuscript. EN assisted in data collection, contributed to data analysis and interpretation, and reviewed and revised the manuscript. GH, EL, and FA assisted in data collection and interpretation, and reviewed and revised the manuscript. RS contributed to data interpretation, and critically reviewed the manuscript for important intellectual content. JA contributed to study design and conceptualization, data analysis and interpretation, and drafted, reviewed, and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Fanny Söderström, Erik Normann, Fredrik Ahlsson, Richard Sindelar & Johan Ågren

  2. Department of Neuroscience, Uppsala University, Uppsala, Sweden

    Gerd Holmström & Eva Larsson

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  1. Fanny Söderström
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Correspondence to Fanny Söderström.

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Söderström, F., Normann, E., Holmström, G. et al. Reduced rate of treated retinopathy of prematurity after implementing lower oxygen saturation targets. J Perinatol 39, 409–414 (2019). https://doi.org/10.1038/s41372-018-0300-y

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