Time to regain birth weight - a marker to predict the severity of retinopathy of prematurity?

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 (BW) be used as an additional marker to identify infants with type 1 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 tertiary neonatal intensive care unit in Australia were included. Twenty-seven preterm infants with Type 1 ROP were identified. Controls (No ROP or ROP other than type 1) were matched with cases on gestational age at birth and BW (1:4 ratio). Data were collected from the database and medical records. Results The median (IQR) gestational age for Type 1 ROP and control groups were 24 (24–26) and 25 (24–26) weeks respectively and median (IQR) BW for Type 1 ROP and control groups were 675 (635–810) and 773 (666–884) grams respectively. Preterm infants with Type 1 ROP were more likely to be small for gestational age (SGA) (18.5% vs 3.7%, p = 0.015) and had increased weeks on oxygen therapy (median 11.9 vs 9.1, p = 0.028). Time to regain BW was longer in preterm infants with type 1 ROP than controls but did not reach statistical significance (median 9 vs 7 days, OR 1.08, 95% CI 1.00–1.17, p = 0.059) adjusted for SGA and duration of oxygen therapy. The area under the curve from the time to regain BW model with adjustment for SGA and duration of oxygen therapy was 0.73 (95% CI 0.62–0.83). Conclusion We hypothesize that time to regain BW has potential to aid prediction of Type 1 ROP and this warrants further investigation in a larger prospective study.

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Environment, Genes, and Alcohol

PEDIATRICS ◽

10.1542/peds.71.6.989a ◽

1983 ◽

Vol 71 (6) ◽

pp. 989-990

Author(s):

NANCY L. GOLDEN

Keyword(s):

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Gestational Age ◽

Control Groups ◽

Low Socioeconomic ◽

Significant Difference ◽

Infant Outcome ◽

Gestational Age At Birth ◽

And Control ◽

Age At Birth

In Reply.— Casey's point is well taken. An association between socioeconomic status and infant outcome has been documented. Our study and control groups were not matched on that factor, but on age, race, and gestational age at birth. A retrospective analysis of the socioeconomic status of study and control mothers indicates that they are all of low socioeconomic status (Hollingshead groups 4 and 5) and that there is no significant difference between the study and control groups.

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Incidence and Characteristics of Infants with Retinopathy of Prematurity in Croatia

Integrative Pediatrics and Child Care ◽

10.18314/ipcc.v1i1.1258 ◽

2018 ◽

Vol 1 (1) ◽

pp. 35-45

Author(s):

Mirjana Vucinovic ◽

Ljubo Znaor ◽

Ana Vucinovic ◽

Vesna Capkun ◽

Julijana Bandic

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Small For Gestational Age ◽

Neonatal Intensive Care ◽

Type 1 Rop

PURPOSE: To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit in Croatia and obtain information on risk factors associated with ROP. There have been limited studies on ROP in Croatia where the screening for ROP and its treatment is still insufficient and not introduced in many intensive care units. MATERIAL AND METHODS: This retrospective study included 247 premature infants admitted to the neonatal intensive care unit of University Hospital Split, over a 5-year period between January 2012, and December 2016. In this paper the relationship between clinical risk factors and the development of ROP was analyzed. RESULTS: The overall incidence for ROP was 23,9 % (59 infants), for Type 1 ROP was 9,3% (23 infants); for Type 2 ROP was 14,6% (36 infants). Median gestational age (GA) and birthweight (BW) were significantly lower among infants with ROP versus those without ROP (29: 23-34 vs. 31: 23-34,p<0,001 and 1,180:630-2,000 vs. 1485:590-2000, p<0,001 respectively). Multivariate analysis showed that only BW (p=0,029) and small for gestational age (SGA) (p=0,045) predicted the development of ROP. CONCLUSION: Birth weight and small for gestational age were the most significant risk factors for developing ROP. In comparison with studies from highly developed countries, infants with a much wider range of gestational age and birth weights are developing Type 1 ROP.

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

Neonatology ◽

10.1159/000511262 ◽

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

Introduction: 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). Methods: 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. Results: 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. Conclusion: 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.

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USING LU SCORE TO PREDICT EXTUBATION FAILURE IN PRETERM INFANTS SHOULD CONSIDER GESTATIONAL AGE AT BIRTH

10.22541/au.159863522.21322912 ◽

2020 ◽

Author(s):

Almudena Alonso Ojembarrena ◽

Francesco Raimondi

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Extubation Failure ◽

Gestational Age At Birth ◽

Age At Birth

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The use of protective red light filter glasses as a m ethod of preventing the development and progression of retinopathy of prematurity, based on the phenomenon of preconditioning photostimulation

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-388-395 ◽

2021 ◽

pp. 388-395

Author(s):

O.A. Ushnikova ◽

◽

A.N. Epikhin ◽

Y.N. Epikhina ◽

A.N. Ushnikov ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Red Light ◽

Light Filter ◽

Adverse Outcomes ◽

Control Groups ◽

Light Filters ◽

And Control ◽

Surgical Laser

Purpose. To study the possible effect of protective red light filter glasses as a method of preventing retinopathy of prematurity, based on the phenomenon of preconditioning photostimulation. Material and methods. For this study, we selected 20 children (40 eyes) from 26.5 to 36 weeks of gestational age and a birth weight of 650 to 2650 grams. All children were divided into 2 groups – the main and control groups of 10 children (20 eyes) each. Results. In the main group of the study, with the use of protective red light filter glasses, the best indicators of the electroretinogram were noted. Conclusions. The use of glasses with red protective light filters-as a method based on the phenomenon of preconditioning photostimulation, is a simple and affordable method of preventing retinopathy of prematurity, which reduces the need for surgical laser treatment and the number of adverse outcomes of this disease. Key words: retinopathy of prematurity, methods of prevention of retinopathy of prematurity.

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Effects of Myo-inositol on Type 1 Retinopathy of Prematurity Among Preterm Infants <28 Weeks’ Gestational Age

JAMA ◽

10.1001/jama.2018.14996 ◽

2018 ◽

Vol 320 (16) ◽

pp. 1649 ◽

Cited By ~ 7

Author(s):

Dale L. Phelps ◽

Kristi L. Watterberg ◽

Tracy L. Nolen ◽

Carol A. Cole ◽

C. Michael Cotten ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity

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Fluorescein Angiography of Persistent Incomplete Vascularization of the Retina After Bevacizumab Therapy in Retinopathy of Prematurity

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419850980 ◽

2019 ◽

Vol 3 (5) ◽

pp. 304-308 ◽

Cited By ~ 1

Author(s):

Xihui Lin ◽

Sagar B. Patel ◽

Alice Y. Zhang ◽

Daniel A. Brill ◽

Kim H. Le ◽

...

Keyword(s):

Fluorescein Angiography ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Peripheral Retina ◽

Medical Systems ◽

Retrospective Case ◽

Type 1 Rop

Purpose: This study evaluates the vascular development of premature infants at 50 weeks postconception after treatment with intravitreal bevacizumab for type 1 retinopathy of prematurity (ROP). Methods: A retrospective case series was conducted on type 1 ROP neonates with a high risk of general anesthesia complications. Patients were treated with bevacizumab between February 2013 and February 2016. At 50 weeks’ gestational age, all patients were imaged with RetCam (Clarity Medical Systems, Inc) fundus photographs and widefield fluorescein angiography (FA). Results: There were 4 boys and 7 girls with an average gestational age of 24.8 weeks and weight of 734.3 grams at birth. The estimated gestational age at injection was 37.1 weeks. Examination under anesthesia with FA was performed at a mean of 61 weeks posttreatment. Nineteen of 20 eyes (95%) of 11 infants had incomplete vascularization and peripheral nonperfusion on imaging. FA showed new vessels with increased tortuosity, microvascular abnormalities, and leakage past the original ridge. These 19 patients were treated with confluent ablative photocoagulation to the peripheral nonperfused retina. Patients were followed for a mean of 73.3 weeks after birth. None required incisional surgery. Conclusions: Patients with type 1 ROP treated with bevacizumab may have delayed vascularization of the peripheral retina and even late recurrence of active disease. Clinicians should regularly monitor patients after bevacizumab for potential neovascular complications.

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Nonphysiological anaemia of prematurity.

Archives of Disease in Childhood ◽

10.1136/adc.53.11.855 ◽

1978 ◽

Vol 53 (11) ◽

pp. 855-860 ◽

Cited By ~ 96

Author(s):

C A Wardrop ◽

B M Holland ◽

K E Veale ◽

J G Jones ◽

O P Gray

Keyword(s):

Preterm Infants ◽

Clinical Features ◽

Gestational Age ◽

Clinical Consequence ◽

Feeding Difficulties ◽

High O2 ◽

Anaemia Of Prematurity ◽

Hb Concentration ◽

Gestational Age At Birth ◽

Age At Birth

Clinical and haematological findings at the nadir of the refractory, early anaemia of prematurity were compared in a study of 95 preterm infants. 53% of 30 babies less than 32 weeks' gestational age at birth had abnormal clinical features resulting from anaemia at its nadir, with a combination of tachycardia, tachypnoea, dyspnoea and feeding difficulties, diminished activity, and pallor. The expression 'available oxygen', derived from the Hb concentration and Hb-O2 affinity, correlated more closely with clinical features of anaemia that did the Hb concentration alone. A formula is presented that predicts the 'available oxygen', provided the Hb concentration and post-conceptual age are known; this avoids the need for direct measurement of Hb-O2 affinity. Clinical anaemia is common in preterm infants with Hb concentrations of up to 10.5 g/dl, consequent on the high O2 affinity of fetal Hb. This is the first description of any common clinical consequence of high Hb-O2 affinity.

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