Oxygen saturation targets for preterm infants on supplemental oxygen and how targets influence retinopathy of prematurity risk.

• A. 88–92% for extremely preterm infants to minimize oxygen toxicity and ROP risk
• B. 95–100%
• C. 98–100%
• D. 60–85%

Answer: (A)

Oxygen saturation targets in extremely preterm infants are chosen to balance delivering enough oxygen with minimizing oxygen-related injury to the developing retina. When oxygen exposure is too high, the retina experiences hyperoxia, leading to vaso-obliteration and oxidative stress that promote abnormal vessel growth. As oxygen is reduced, the retina can become hypoxic, triggering neovascularization that can progress to retinopathy of prematurity and potential retinal detachment. Therefore, targeting a lower saturations range helps limit this oxidative damage and flare-up of abnormal vessels without causing dangerous hypoxemia. The 88–92% range for extremely preterm infants on supplemental oxygen is designed to reduce the risk of ROP while still maintaining sufficient oxygenation. In contrast, saturations in the mid- to high-90s or above (too high) increase ROP risk, while saturations that are too low (like 60–85%) risk systemic hypoxemia and organ injury, including the brain.