Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA.
Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Pediatr Res. 2024 Aug;96(3):766-772. doi: 10.1038/s41390-024-03169-5. Epub 2024 Apr 10.
Intermittent hypoxemia (IH) may influence retinopathy of prematurity (ROP) development in preterm infants, however, previous studies had mixed results. This study tests the hypothesis that increased IH is associated with Type 1 ROP; a stage beyond which treatment is indicated.
IH was quantified by continuously monitoring oxygen saturation (SpO) using high-resolution pulse oximeters during the first 10 weeks of life. Statistical analyses assessed the relationship and predictive ability of weekly and cumulative IH for Type 1 ROP development.
Most analyses showed no association between IH and Type 1 ROP adjusting for gestational age (GA) and birth weight (BW). However, cumulative IH of longer duration during weeks 5-10, 6-10, and 7-10 were significantly associated with Type 1 ROP adjusting for GA and BW, e.g., the adjusted odds ratio of Type 1 ROP was 2.01 (p = 0.03) for every 3.8 seconds increase in IH duration from week 6-10. IH did not provide statistically significant added predictive ability above GA and BW.
For most analyses there was no significant association between IH and Type 1 ROP adjusting for GA and BW. However, infants with longer IH duration during the second month of life had higher risk for Type 1 ROP.
The relationship and predictive ability of intermittent hypoxemia (IH) on retinopathy of prematurity (ROP) is controversial. This study shows no significant association between IH events and Type 1 ROP after adjusting for gestational age (GA) and birth weight (BW), except for cumulative IH of longer duration in the second month of life. In this cohort, IH does not provide a statistically significant improvement in ROP prediction over GA and BW. This study is the first to assess the cumulative impact of IH measures on Type 1 ROP. Interventions for reducing IH duration during critical postnatal periods may improve ROP outcomes.
间歇性低氧血症（IH）可能会影响早产儿的视网膜病变（ROP）的发展，但之前的研究结果不一。本研究检验了这样一个假设，即 IH 增加与 1 型 ROP 有关；这是一个需要治疗的阶段。
通过使用高分辨率脉搏血氧仪在生命的前 10 周内连续监测氧饱和度（SpO2）来量化 IH。统计分析评估了每周和累积 IH 与 1 型 ROP 发展之间的关系和预测能力。
大多数分析表明，在调整胎龄（GA）和出生体重（BW）后，IH 与 1 型 ROP 之间没有关联。然而，在调整 GA 和 BW 后，第 5-10 周、第 6-10 周和第 7-10 周的较长时间内的累积 IH 与 1 型 ROP 显著相关，例如，第 6-10 周 IH 持续时间每增加 3.8 秒，1 型 ROP 的调整比值比为 2.01（p=0.03）。IH 并没有提供 GA 和 BW 以上的统计学上显著的预测能力。
对于大多数分析，在调整 GA 和 BW 后，IH 与 1 型 ROP 之间没有显著关联。然而，在生命的第二个月，IH 持续时间较长的婴儿患 1 型 ROP 的风险更高。
间歇性低氧血症（IH）与早产儿视网膜病变（ROP）的关系和预测能力存在争议。本研究表明，在调整胎龄（GA）和出生体重（BW）后，除了生命的第二个月累积 IH 持续时间较长外，IH 事件与 1 型 ROP 之间没有显著关联。在这个队列中，IH 并没有在 ROP 预测方面提供 GA 和 BW 的统计学显著改善。本研究是第一个评估 IH 测量对 1 型 ROP 的累积影响的研究。在关键的产后期间减少 IH 持续时间的干预措施可能会改善 ROP 结果。
