Continuous oxygen saturation and risk of retinopathy of prematurity in a Japanese cohort

Background/aims We assessed the associations between retinopathy of prematurity (ROP) and continuous measurements of oxygen saturation (SpO 2 ), and developed a risk prediction model for severe ROP using birth data and SpO 2 data. Methods This retrospective study included infants who were born before 30 weeks of gestation between August 2009 and January 2019 and who were screened for ROP at a single hospital in Japan. We extracted data on birth weight (BW), birth length, gestational age (GA) and minute-by-minute SpO 2 during the first 20 days from the medical records. We defined four SpO 2 variables using sequential measurements. Multivariate logistic regression was used to develop a model that combined birth data and SpO 2 data to predict treatment-requiring ROP (TR-ROP). The model’s performance was evaluated using the area under the receiver operating characteristic curve (AUC). Results Among 350 infants, 83 (23.7%) required ROP treatment. The SpO 2 variables in infants with TR-ROP differed significantly from those with non-TR-ROP. The average SpO 2 and high SpO 2 showed strong associations with GA (r=0.73 and r=0.70, respectively). The model incorporating birth data and the four SpO 2 variables demonstrated good discriminative ability (AUC=0.83), but it did not outperform the model incorporating BW and GA (AUC=0.82). Conclusion Data obtained by continuous SpO 2 monitoring demonstrated valuable associations with severe ROP, as well as with GA. Differences in the distribution of average SpO 2 and high SpO 2 between infants with TR-ROP and non-TR-ROP could be used to establish efficient cut-off values for risk determination.