RT Journal Article
SR Electronic
T1 Effects of fetal haemoglobin on systemic oxygenation in preterm infants and the development of retinopathy of prematurity PacIFiHER Report No. 2
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP bjophthalmol-2021-319546
DO 10.1136/bjophthalmol-2021-319546
A1 Kim Jiramongkolchai
A1 Michael X Repka
A1 Jing Tian
A1 Sue W Aucott
A1 Jennifer Shepard
A1 Megan Collins
A1 Julia Clemens
A1 Mia Feller
A1 Irina Burd
A1 Marina Roizenblatt
A1 Kerry Smith
A1 J Fernando Arevalo
A1 Peter L Gehlbach
A1 James T Handa
A1 ,
YR 2021
UL http://bjo.bmj.com/content/early/2021/10/06/bjophthalmol-2021-319546.abstract
AB Background/aims Fetal haemoglobin (HbF) has an oxyhaemoglobin dissociation curve that may affect systemic oxygenation and the development of retinopathy of prematurity (ROP). The study aim is to characterise the effects of HbF levels on systemic oxygenation and ROP development.Methods Prospective study conducted from 1 September 2017 through 31 December 2018 at the Johns Hopkins NICU. Preterm infants with HbF measured at birth, 31, 34 and 37 weeks post-menstrual age (PMA), complete blood gas and SpO2 recorded up to 42 weeks PMA, and at least one ROP exam were included.Results Sixty-four preterm infants were enrolled. Higher HbF was associated with significantly higher SpO2, lower PCO2, lower FiO2 from birth to 31 weeks PMA and 31 to 34 weeks PMA (rs=0.51, rs=−0.62 and rs=−0.63; p<0.0001 and rs=0.71, rs=−0.58 and rs=−0.79; p<0.0001, respectively). To maintain oxygen saturation goals set by the neonatal intensive care unit, higher median FiO2 was required for HbF in the lowest tercile from birth compared with HbF in the highest tercile to 31 weeks and 31 to 34 weeks PMA; FiO2=35 (21–100) versus 21 (21–30) p<0.006 and FiO2=30 (28–100) versus 21 (21–30) p<0.001, respectively. Preterm infants with ROP had poorer indices of systemic oxygenation, as measured by median levels of SpO2 and PCO2, and lower levels of HbF (p<0.039 and p<0.0001, respectively) up to 34 weeks PMA.Conclusion Low HbF levels correlated with poor oxygenation indices and increased risk for ROP. O2 saturation goals to prevent ROP may need to incorporate relative amount of HbF.All data relevant to the study are included in the article or uploaded as online supplemental information. All data relevant to this study are included in the article.