scholarly journals High-Dose Erythropoietin in Extremely Low Gestational Age Neonates Does Not Alter Risk of Retinopathy of Prematurity

Neonatology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Dennis E. Mayock ◽  
Zimeng Xie ◽  
Bryan A. Comstock ◽  
Patrick J. Heagerty ◽  
Sandra E. Juul ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
High Frequency ◽  
High Dose ◽  
Heart Murmur ◽  
Treatment Groups ◽  
Increased Risk ◽  
Gestational Age At Birth ◽  
Age At Birth

<b><i>Introduction:</i></b> The Preterm Erythropoietin (Epo) Neuroprotection (PENUT) Trial sought to determine the safety and efficacy of early high-dose Epo as a potential neuroprotective treatment. We hypothesized that Epo would not increase the incidence or severity of retinopathy of prematurity (ROP). <b><i>Methods:</i></b> A total of 941 infants born between 24–0/7 and 27–6/7 weeks’ gestation were randomized to 1,000 U/kg Epo or placebo intravenously for 6 doses, followed by subcutaneous or sham injections of 400 U/kg Epo 3 times a week through 32 weeks post-menstrual age. In this secondary analysis of PENUT trial data, survivors were evaluated for ROP. A modified intention-to-treat approach was used to compare treatment groups. In addition, risk factors for ROP were evaluated using regression methods that account for multiples and allow for adjustment for treatment and gestational age at birth. <b><i>Results:</i></b> Of 845 subjects who underwent ROP examination, 503 were diagnosed with ROP with similar incidence and severity between treatment groups. Gestational age at birth, birth weight, prenatal magnesium sulfate, maternal antibiotic exposure, and presence of heart murmur at 2 weeks predicted the development of any ROP, while being on high-frequency oscillator or high-frequency jet ventilation (HFOV/HFJV) at 2 weeks predicted severe ROP. <b><i>Conclusion:</i></b> Early high-dose Epo followed by maintenance dosing through 32 weeks does not increase the risk of any or severe ROP in extremely low gestational age neonates. Gestational age, birth weight, maternal treatment with magnesium sulfate, antibiotic use during pregnancy, and presence of a heart murmur at 2 weeks were associated with increased risk of any ROP. Treatment with HFOV/HFJV was associated with an increased risk of severe ROP.

scholarly journals Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme

2020 ◽  
Vol 47 (2) ◽  
pp. 55-60
Author(s):  
B.A. Olusanya ◽  
T.S. Oluleye ◽  
O.O. Tongo ◽  
M.O. Ugalahi ◽  
Y.O. Babalola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Screening Criteria ◽  
Screening Programs ◽  
Significant Difference ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Rop Screening

Background: Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the  development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening  program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks.  Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those  without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening  programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards  developing country-specific screening guidelines. Keywords: Retinopathy; Prematurity; Preterm; Neonates; Nigeria; Africa

scholarly journals Time to Regain Birth Weight - A Marker to Predict the Severity of Retinopathy of Prematurity?

2021 ◽  
Author(s):  
Ajay Anvekar ◽  
Sam E Athikarisamy ◽  
Shripada Rao ◽  
Andy Gill ◽  
Elizabeth A. Nathan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Uterine Growth ◽  
Level 3 ◽  
Gestational Age At Birth ◽  
Age At Birth

Abstract Background: Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight be used as an additional marker to identify infants needing treatment for ROP.Methods: In this retrospective study, preterm infants (<27 weeks gestational age at birth) born during the period from 1/1/2010-31/12/2015 at a level 3 neonatal intensive care unit in Australia were included. 27 cases (ROP needing treatment) were identified. Controls (ROP not needing treatment or no ROP) were matched with cases on gestational age at birth and birthweight (1:4 ratio). Data were collected from the database and medical records.Results: The median (IQR) gestational age for cases and controls were 24 (24-26) and 25 (24-26) weeks respectively and median (IQR) birthweight for cases and controls were 675 (635-810) and 773 (666-884) grams respectively. Cases were more likely to be intra uterine growth restricted (18.5% vs 3.7%, p=0.015) and had increased weeks on oxygen (median 11.9 vs 9.1, p=0.028). Median (IQR) time to regain birth weight in cases and controls were 9 (6-13) and 7 (5-10) days respectively. Time to regain birthweight approached statistical significance when adjusted for duration of oxygen (aOR 1.08, 95% CI 1.00-1.17, p=0.054). The area under the curve from the time to regain BW ROC analysis with adjustment for IUGR and duration of oxygen was 0.73 (95% CI 0.62-0.83).Conclusion: Time to regain BW has potential to aid prediction of ROP needing treatment.

scholarly journals 512: Are appropriately sized fetuses who “fall off the curve” at increased risk for small-for-gestational age at birth?

2018 ◽  
Vol 218 (1) ◽  
pp. S306-S307
Author(s):  
Nathan R. Blue ◽  
Mariam Savabi ◽  
Meghan E. Beddow ◽  
Vivek R. Katukuri ◽  
Cody M. Fritts ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Increased Risk ◽  
Gestational Age At Birth ◽  
Age At Birth

scholarly journals Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

2018 ◽  
Vol 61 (7) ◽  
pp. 1784-1793
Author(s):  
Lilian Cássia Bórnia Jacob-Corteletti ◽  
Eliene Silva Araújo ◽  
Josilene Luciene Duarte ◽  
Fernanda Zucki ◽  
Kátia de Freitas Alvarenga
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Pure Tone ◽  
Broadband Noise ◽  
Acoustic Reflex ◽  
Group I ◽  
Group Ii ◽  
Gestational Age At Birth ◽  
Age At Birth

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

Developmental and Psychological Test Scores in Children of Low Birth Weight

PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 886-887
Author(s):  
Linda C. Eaves ◽  
Harry Klonoff ◽  
Henry G. Dunn
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Test Scores ◽  
Personal Communication ◽  
Psychological Test ◽  
January Issue ◽  
The Subject ◽  
Gestational Age At Birth ◽  
Age At Birth

In the printing of our article on the subject in the January issue of Pediatrics (45:9, 1970) the wording of a sentence on page 10 was unfortunately changed in such a manner as to distort the personal communication we had received from Dr. Ruth Griffiths in London, England. As printed, the sentence is: "It does not seem admirable to try and meaningful to correct such D.Q. figures according to gestational age at birth." The statement we wished to make was: "It does not seem advisable to try and correct such D.Q. figures according to gestational age at birth."

scholarly journals Peri-intraventricular hemorrhage in newborns weighing less than 1500 grams: comparative analysis between 2 institutions

2003 ◽  
Vol 58 (6) ◽  
pp. 299-304
Author(s):  
Marinice Duarte da Ponte ◽  
Sérgio Tadeu Martins Marba
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
World Literature ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Maternity Hospital ◽  
State University ◽  
Gestational Age At Birth ◽  
Age At Birth

PURPOSE: This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance. METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS: We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks. CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of peri-intraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.

scholarly journals Risk of hypertension into adulthood in persons born prematurely: a national cohort study

2019 ◽  
Vol 41 (16) ◽  
pp. 1542-1550 ◽  
Author(s):  
Casey Crump ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Environmental Factors ◽  
Gestational Age ◽  
Large Population ◽  
Increased Risk ◽  
Extremely Preterm ◽  
National Cohort ◽  
Gestational Age At Birth ◽  
Age At Birth

Abstract Aims Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973–2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18–29 years associated with preterm (&lt;37 weeks) and extremely preterm (22–27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21–1.36] and 2.45 (1.82–3.31), respectively, and at ages 30–43 years were 1.25 (1.18–1.31) and 1.68 (1.12–2.53), respectively, compared with full-term birth (39–41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-term monitoring for the development of hypertension.

scholarly journals The effects of Fetal Surgery on Retinopathy of Prematurity Development

2009 ◽  
Vol 1 ◽  
pp. OED.S2746 ◽  
Author(s):  
Sudha Nallasamy ◽  
Stefanie L. Davidson ◽  
Lori J. Howell ◽  
Holly Hedrick ◽  
Alan W. Flake ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Fetal Surgery ◽  
Retrospective Chart Review ◽  
Sacrococcygeal Teratoma ◽  
Arterial Perfusion ◽  
Mediastinal Teratoma ◽  
Increased Risk ◽  
Fetal Malformations

Background Fetal surgery is selectively offered for severe or life-threatening fetal malformations. These infants are often born prematurely and are thus at risk for retinopathy of prematurity (ROP). It is not known whether fetal surgery confers an increased risk of developing severe ROP relative to published rates in standard premature populations ≤37 weeks of age grouped by birth weight (<1500 grams or ≥1500 grams). Design This is a retrospective chart review. Methods We reviewed the charts of 137 patients who underwent open fetal/fetoscopic surgery from 1996–2004. Surgical indications included twin-twin transfusion syndrome (TTTS), myelomeningocele (MMC), congenital diaphragmatic hernia (CDH), sacrococcygeal teratoma (SCT), cystic adenomatoid malformation of the lung (CCAM), and twin reversed arterial perfusion sequence (TRAP). Of these, 17 patients had local ROP examination data. Binomial tests were performed to assess whether rates of ROP in our fetal/fetoscopic surgery cohort were significantly different from published rates. Results There were 5 patients each with an underlying diagnosis of TTTS and MMC, 2 patients each with CDH and TRAP, and 1 patient each with SCT, CCAM, and mediastinal teratoma. The mean gestational age at surgery was 23 4 /7 ± 2 3 /7 weeks, mean gestational age at birth was 30 ± 2 5 /7 weeks, and mean birth weight was 1449 ± 510 grams (610–2485). Compared to published rates of ROP and threshold ROP, our fetal surgery patients had significantly higher rates of ROP and threshold ROP in both the <1500 grams and the ≥1500 grams group (all p-values <0.05). Conclusions Fetal/fetoscopic surgery appears to significantly increase the rate of ROP and threshold ROP development. Greater numbers are needed to confirm these observations.

Treatment of 139 Pregnancies in Antiphospholipid-positive Women Not Fulfilling Criteria for Antiphospholipid Syndrome: A Retrospective Study

2013 ◽  
Vol 40 (4) ◽  
pp. 425-429 ◽  
Author(s):  
Teresa Del Ross ◽  
Amelia Ruffatti ◽  
Maria Serena Visentin ◽  
Marta Tonello ◽  
Antonia Calligaro ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Antiphospholipid Antibody ◽  
Birth Weight Percentile ◽  
Antibody Profile ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Weight Percentile

Objective.The effect of low-dose aspirin (LDA) on pregnancy outcome in antiphospholipid (aPL)-positive women not fulfilling the criteria for antiphospholipid antibody syndrome (APS) was evaluated retrospectively.Methods.We evaluated 139 pregnancies of 114 aPL-positive women not fulfilling the Sydney classification criteria for definite APS (104 treated with LDA, 35 untreated). Inclusion criteria consisted of (1) any titer of aPL and no previous pregnancy or no pregnancy losses (defined as aPL carriers); (2) any titer of aPL and 1 or 2 pregnancy losses before the 10th gestational week. No women had previous thrombosis. The rate of pregnancy loss, gestational age at delivery, and birth weight percentile were compared in the treated and untreated patients. Associations between clinical and laboratory characteristics and pregnancy outcomes were investigated.Results.The rate of pregnancy loss was low in both treated and untreated groups (7.7% vs 2.9%, respectively). There were no statistically significant differences in the rate of pregnancy loss, gestational age at birth, or birth weight percentile in the treated and untreated groups. There were significant associations between gestational age at birth ≤ 34th week and positivity for lupus anticoagulant (p = 0.025) and anti-ß2-glycoprotein I IgG antibodies at titers > 99th (p = 0.016).Conclusion.LDA treatment does not appear to improve pregnancy outcome in low-risk women not fulfilling the criteria for APS. Because antibody profile seems to influence pregnancy outcome, further studies of patients stratified according to their antibody profile are warranted.

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