AIM: To determine the effect of lowered target oxygen saturation levels on and identify risk factors of retinopathy of prematurity(ROP)in neonatal respiratory distress syndrome(RDS).

METHODS: Medical records of consecutive preterm infants(N=252)diagnosed with RDS between Jan. 2009 and Dec. 2012 were retrospectively reviewed. The patients were divided into higher-saturation(90-97%; n=116)and lower-saturation(85-93%; n=136)groups according to their target oxygen saturation ranges. ROP severity was assessed and relevant systemic parameters were evaluated.

RESULTS: Incidence of ROP, need for laser ablation, and proportion of aggressive posterior ROP were not significantly different between the groups, but the lower-saturation group had a better survival rate(P=0.005). Patients who spent an additional day in incubator care had a 1.041 times greater chance of developing ROP(odds ratio=1.041; 95% CI=1.003-2.275; P=0.002), whereas a one-point increase in the 5min Apgar score reduced the possibility by 24.7%(odds ratio=0.753; 95% CI=0.152-0.965; P=0.033).

CONCLUSION: Target oxygen saturation levels of 85% to 93% may improve survival without affecting ROP development in infants with RDS. The relevant risk factors are duration of incubator care and 5-min Apgar score.