Objective Retinopathy of prematurity (ROP), a vasoproliferative disorder of the retina in preterm infants, has been associated with multiple factors including levels of oxygenation. As intermittent hypoxemic events are common in preterm infants, this study investigates their association with the development of ROP. Study Design Oxygen desaturation events were quantified in 79 preterm infants (gestational age 24–27 6/7wks) during the first 8 weeks of life. Infants were classified as requiring laser treatment for ROP (LaserROP) versus less severe or no ROP. A linear mixed model was used to study the association between the incidence of intermittent hypoxia and LaserROP, controlling for gestational age, gender, race, multiple births and initial severity of illness. Results For all infants, there was an increase in hypoxemic events with increasing postnatal age (p<0.001). Controlling for all covariates, a higher incidence of oxygen desaturation events was found in the LaserROP infants (p<0.001), males (p<0.02) and infants of younger gestational age (p<0.003). Conclusion This study demonstrated a higher incidence of hypoxemic events in infants with ROP requiring laser therapy. Therapeutic strategies to optimize baseline oxygenation in preterm infants should include minimization of desaturation episodes, which may in turn decrease serious morbidity in this high risk population.

Background:We have previously shown an increased incidence of intermittent hypoxemia (Ih) events in preterm infants with severe retinopathy of prematurity (ROP). animal models suggest that patterns of Ih events may play a role in ROP severity as well. We hypothesize that specific Ih event patterns are associated with ROP in preterm infants. Methods: Variability in Ih event duration, severity, and the time interval between Ih events (≤80%, ≥10 s, and ≤3 min) along with the frequency spectrum of the oxygen saturation (spO 2 ) waveform were assessed. results: severe ROP was associated with (i) an increased mean and sD of the duration of Ih event (P < 0.005), (ii) more variability (histogram entropy) of the time interval between Ih events (P < 0.005), (iii) a higher Ih nadir (P < 0.05), (iv) a time interval between Ih events of 1-20 min (P < 0.05), and (v) increased spectral power in the range of 0.002-0.008 hz (P < 0.05), corresponding to spO 2 waveform oscillations of 2-8 min in duration. spectral differences were detected as early as 14 d of life. conclusion: severe ROP was associated with more variable, longer, and less severe Ih events. Identification of specific spectral components in the spO 2 waveform may assist in early identification of infants at risk for severe ROP.

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