neoprom 2014

Retinopathy of prematurity (ROP) is the leading cause of vision loss in children. A well-known risk factor for the development of ROP is duration of oxygen supplementation. Other postnatal factors have also been associated with ROP risk, including poor post-natal weight gain. The weight, insulin-like growth factor, neonatal retinopathy of prematurity (WINROP) algorithm predicts severe ROP based on postnatal weight gain and has been validated in several studies,1,2 including a high sensitivity for prediction of severe ROP in our local NICU populations...

IMPORTANCE: There are potential benefits and harms of hyperoxemia and hypoxemia for extremely preterm infants receiving more vs less supplemental oxygen. OBJECTIVE: To compare the effects of different target ranges for oxygen saturation as measured by pulse oximetry (Spo2) on death or major morbidity. DESIGN, SETTING, AND PARTICIPANTS: Prospectively planned meta-analysis of individual participant data from 5 randomized clinical trials (conducted from 2005-2014) enrolling infants born before 28 weeks' gestation...

BACKGROUND: The appropriate level of oxygenation for extremely preterm neonates (<28 weeks' gestation) to maximise the greatest chance of survival, without incurring significant morbidity, remains unknown. Infants exposed to lower levels of oxygen (targeting oxygen saturations of <90%) in the first weeks of life are at increased risk of death, cerebral palsy, patent ductus arteriosus, pulmonary vascular resistance and apnoea, whilst those maintained in higher levels of oxygen (targeting oxygen saturations of >90%) have been reported to have greater rates of morbidity including retinopathy of prematurity and chronic lung disease...