Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Richard A. Ehrenkranz

Subject Area(s)

Medicine

Abstract

BLOOD GASES AND RETINOPATHY OF PREMATURITY: THE EXTREMELY LOW GESTATIONAL AGE NEWBORN STUDY. Alisse K. Hauspurg and Richard A. Ehrenkranz. Department of Pediatrics, Yale University School of Medicine, New Haven, CT.

This study tested the hypothesis that preterm infants who had a blood gas derangement on at least 2 of the first 3 postnatal days are at increased risk for more severe retinopathy of prematurity (ROP). 1,042 infants born before 28 weeks gestational age (GA) were included. An infant was considered at risk if his/her blood gas measure was in the highest or lowest quartile for GA on at least 2 of the first 3 postnatal days. Multivariable models adjusting for confounders indicate that exposure to a PCO2 in the highest quartile predicts ROP stage 3, 4 or 5: (OR = 1.6, 95% CI = 1.1-2.3); zone 1: 2.0, 1.1-3.6; prethreshold/threshold: 1.9, 1.2-3.0; plus disease: 1.8, 1.1-2.9. Estimates are similar for a low pH for zone 1 (2.1, 1.2-3.8), prethreshold/threshold (1.8, 1.1-2.8), but did not quite achieve statistical significance for ROP stage 3, 4, or 5 (1.4, 0.9-2.0) and plus disease (1.5, 0.9-2.4). A PaO2 in the highest quartile for GA on at least 2 of the first 3 postnatal days was associated with a doubling of the risk of ROP in zone 1 (2.5, 1.4-4.4) and of prethreshold/threshold disease (2.1, 1.4-3.3), a 70% risk increase for plus disease (1.7, 1.04-2.8), while a 40% risk increase for ROP stage 3 or higher did not achieve statistical significance (1.4, 0.96-2.0). Infants who experienced high PCO2, low pH and high PaO2 during the first three prenatal days appear to be at increased risk of more severe ROP.

Comments

This is an Open Access Thesis.

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