Reduced rate of treated retinopathy of prematurity after implementing lower oxygen saturation targets

J Perinatol. 2019 Mar;39(3):409-414. doi: 10.1038/s41372-018-0300-y. Epub 2019 Jan 7.


Objective: To evaluate an implementation of lower oxygen saturation targets with retinopathy of prematurity (ROP) as primary outcome, in infants at the lowest extreme of prematurity.

Study design: Retrospective cohort including infants born at 22-25 weeks of gestation in 2005-2015 (n = 325), comparing high (87-93%) and low (85-90%) targets; infants transferred early were excluded from the main analysis to avoid bias.

Results: Overall survival was 76% in high saturation era, and 69% in low saturation era (p = .17). Treatment-requiring ROP was less common in low saturation group (14% vs 28%, p < .05) with the most prominent difference in the most immature infants. Including deceased infants in the analysis, necrotizing enterocolitis was more frequent in low saturation era (21% vs 10%, p < .05).

Conclusions: Implementing lower saturation targets resulted in a halved incidence of treatment-requiring ROP; the most immature infants seem to benefit the most. An association between lower oxygenation and necrotizing enterocolitis cannot be excluded.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Incidence
  • Infant, Extremely Premature
  • Infant, Newborn
  • Logistic Models
  • Male
  • Oxygen / administration & dosage*
  • Oxygen Consumption*
  • Oxygen Inhalation Therapy / methods*
  • Retinopathy of Prematurity / therapy*
  • Retrospective Studies
  • Sweden
  • Tertiary Care Centers


  • Oxygen