scholarly journals The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity

Folia Medica ◽  
2017 ◽  
Vol 59 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Vasil G. Marinov ◽  
Desislava N. Koleva-Georgieva ◽  
Nelly P. Sivkova ◽  
Maya B. Krasteva
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Apgar Score ◽  
Prognostic Significance ◽  
Significant Risk ◽  
Exact Test ◽  
Group I ◽  
Group Ii ◽  
Minute Apgar Score

Abstract Background: A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP). Aim: To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP. Materials and methods: The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher’s exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP. Results: A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively). Conclusion: An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.

scholarly journals Incidence and risk factors of retinopathy of prematurity

2013 ◽  
Vol 53 (2) ◽  
pp. 76
Author(s):  
Rasyidah Rasyidah ◽  
Sujan Ali Fing
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Blood Transfusion ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Exact Test ◽  
Stage 1

Background Retinopathy of prematurity (ROP) is one of themain causes of visual impairment in premature infants.Objective To determine the incidence and risk factors for ROPin premature infants.Methods This retrospective study included premature infantsborn in Stella Maris Women's and Children's Hospital and admittedto the neonatal intensive care unit (NICU) and NeonatologyDepartment from November 2009 to May 2012. We included allpremature infants with body weight (BW) < 1500 g or gestationalage (GA) < 32 weeks, and selected infants with BW 1500 - 2000g or GA > 32 weeks with unstable clinical courses who had beenscreened for ROP. Data was analyzed with Fisher's exact test andindependent t test.Results Of the 48 premature infants in the study, ROP wasdetected in 6 (12.5%) of the subjects. Stages ofROPwere classifiedaccording to the International Classification ofRetinopathyof Prematurity. Stage 1 ROP was detected in 1 (2.1 %) subject;stage 2 ROP was detected in 3 (6.25%) subjects; and stage 3ROP was found in 2 ( 4.2%) subjects. The 2 infants with stage3 ROP required surgery. No ROP was detected in infants withGA ~30 weeks or BW > 1250 g. Respiratory distress syndrome(RDS), sepsis, blood transfusion, and apnea were found to beassociated with development ofROP. Duration of oxygen therapywas found to be a significant risk factor for ROP in a comparisonof the no ROP group to the ROP group: 14.0 (SD 9.508) daysvs. 3.81 (SD 5 .218) days, respectively (P<0.05). In addition,the duration of continuous positive airway pressure (CPAP)usage was also a significant risk factor for ROP, with 1.83 (SD1.329) days in the ROP group vs. 0.76 (SD 1.122) days in theno ROP group (P<0.05).Conclusions The incidence of ROP in the premature infants inour study is 12.5%. Retinopathy of prematurity is associated withlower BW, lower GA, lower Apgar score at the 5th minute, RDS, sepsis, apnea, blood transfusion, aminophylline usage, as well aslonger duration of oxygen therapy and CPAP usages.

scholarly journals Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gordon S. K. Yau ◽  
Jacky W. Y. Lee ◽  
Victor T. Y. Tam ◽  
Stan Yip ◽  
Edith Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Very Low Birth Weight ◽  
Significant Risk ◽  
The Mean ◽  
Record Review ◽  
Chinese Twins ◽  
Retrospective Medical Record Review

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.

Predictive factors for ciclosporin-associated nephrotoxicity in children with minimal change nephrotic syndrome

2011 ◽  
Vol 64 (6) ◽  
pp. 516-519 ◽  
Author(s):  
Ji Hong Kim ◽  
Se Jin Park ◽  
So Jin Yoon ◽  
Beom Jin Lim ◽  
Hyeon Joo Jeong ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Risk Factor ◽  
Predictive Factors ◽  
Trough Level ◽  
Multiple Logistic Regression Analysis ◽  
Significant Risk ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Group I ◽  
Group Ii

AimsTo identify the predictive factors for ciclosporin A (CyA)-associated nephrotoxicity (CAN) in children with minimal change nephrotic syndrome (MCNS).MethodsThe clinical and laboratory findings of 58 children (median age 3.2 years, range 1.1–13.1 years, male:female 48:10) with MCNS who were treated with CyA from 1992 to 2002 were analysed retrospectively. Forty-eight (83%) of them were steroid dependent and 10 (17%) were steroid resistant. The starting dose of CyA was 5 mg/kg per day, and the desired drug level was kept at 100–200 ng/ml. Serial renal biopsies were performed before and after CyA therapy.ResultsTwenty-two patients (38%) had CAN (group I) and 36 (62%) did not (group II). There were no differences in the age at onset, sex, initial response to steroids, duration of CyA therapy and relapse rates. However, the median CyA trough levels were significantly higher in group I than in group II (218.0±15.2 vs 171.8±6.7 ng/ml, p=0.01). Changes in creatinine clearance were more decreased in group I than in group II (−39.4±8.2 vs 2.7±4.3 ml/min per 1.73 m2, p<0.0001). Multiple logistic regression analysis also revealed the median CyA trough level was an independent risk factor for the development of CAN (OR 1.025, 95% CI 1.007 to 1.044, p=0.007).ConclusionsThe median CyA trough level was an independent and significant risk factor for the development of CAN in children with MCNS receiving moderate-dose CyA.

scholarly journals Hyperglycemia but not Glycated Albumin, is Linked to Retinopathy of Prematurity

2020 ◽  
Author(s):  
Ana C Almeida ◽  
Gabriela A Silva ◽  
Gabriele Santini ◽  
Margarida Brízido ◽  
Miguel Correia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Glycated Albumin ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Other ◽  
Reference Ranges ◽  
Extremely Preterm

Abstract Background: Retinopathy of prematurity (ROP) is a neovascular disorder of the immature retina. Neonatal hyperglycemia is a common problem in extremely preterm infants. Several studies have also reported an association between hyperglycemia and ROPPurpose: Our goal was to determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP).Methods: Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained according to the CLSI EP28-A3C. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression.Results: A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1,240g. Thirty-three infants (21,7%) had ROP. Hyperglycemia was present in 24 (72,7%) infants diagnosed with any ROP versus 6 (0,05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00-12.65), 8.20% (5.32-11.67), 8.00% (5.32-10.00) and 7.90% (5.30-9-00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B)28.062, 95%CI for Exp(B) 7.881 - 99.924 p <0.001)Conclusions: In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.

scholarly journals Can 5-minute Apgar score be considered as an additional independent risk factor for screening of retinopathy of prematurity?

2020 ◽  
Vol 8 (1) ◽  
pp. 4-4
Author(s):  
Amir Eftekhari Milani ◽  
Mohamad Reza Niyousha ◽  
Ali Kiavar ◽  
Hanieh Sakha ◽  
Ali Mahdavi Fard ◽  
...  
Keyword(s):  
Risk Factor ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Independent Risk Factor ◽  
P Value ◽  
Cross Sectional ◽  
Minute Apgar Score

Introduction: Because of increasing the population of premature infants due to improving neonatal care we try to find other independent criteria in addition to birth weight and gestational age to reduce the number of infants who need a retinopathy of prematurity (ROP) screening examination. Methods: This is a retrospective cross-sectional study, included 150 preterm infants with gestational age of ≤ 32 weeks or birth weight ≤ 1500 g or receives oxygen therapy for more than 2 days, who were examined from the fourth week of life for ROP in Tabriz Al-Zahra hospital’s neonatal intensive care unit (NICU), from March 2017 to January 2018. All infants with other risk factors such as multi gestational pregnancy, blood transfusion or exchange, phototherapy, underlying disease, cerebral hemorrhage, chronic lung disease and sepsis were excluded from the study. Infants divided to two group ROP (n=47) and non-ROP (n=133) and their 5-minute Apgar score was Apgar score was compared as an independent risk factor. Exploratory data analysis was performed using descriptive measures with independent samples t tests. Kolmogorov-Smirnov tests were used to test the normality of data distribution. Results: The mean 5-minute Apgar scores were statistically lower in ROP group (5.4±2.3) than non-ROP group 6.2±2.1 (P value=0.041). Conclusion: Apgar score was statistically significant, but in light of the very close results obtained, it seems prudent to consider an independent risk factor.

scholarly journals Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
K. M. Friddle ◽  
B. A. Yoder ◽  
M. E. Hartnett ◽  
E. Henry ◽  
R. J. DiGeronimo
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Risk Factor ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Incomplete Data ◽  
Significant Risk ◽  
Screening Strategy ◽  
Screening Guidelines ◽  
Rop Screening

Objective.Current American retinopathy of prematurity (ROP) screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP.Study Design.We performed a 13-year review from Intermountain Health Care (IHC) data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP.Results.We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61%) were included in the study. Overall, severe ROP occurred in 260 (9.3%), but only 11/1601 ≥ 29 weeks (0.7%). All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601) of the screened population.Conclusions.Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.

scholarly journals Correlation between hyperglycemia and glycated albumin with retinopathy of prematurity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana C. Almeida ◽  
Gabriela A. Silva ◽  
Gabriele Santini ◽  
Margarida Brízido ◽  
Miguel Correia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Glycated Albumin ◽  
Laboratory Data ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Other ◽  
Reference Ranges

AbstractTo determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP). Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8 h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression. A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1240 g. Thirty-three infants (21.7%) had ROP. Hyperglycemia was present in 24 (72.7%) infants diagnosed with any ROP versus 6 (0.05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00–12.65), 8.20% (5.32–11.67), 8.00% (5.32–10.00) and 7.90% (5.30–9.00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B) 28.062, 95% CI for Exp(B) 7.881–99.924 p < 0.001). In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.

scholarly journals Value of Neutrophil to Lymphocyte Ratio in Early Prediction of Meconium Aspiration Syndrome

2020 ◽  
Vol 10 (01) ◽  
pp. e207-e211
Author(s):  
Suzan Gad ◽  
Abeer Alkhalafawi ◽  
Syed Raza ◽  
Mervat Hesham ◽  
Mohamed Sheta
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Significant Risk ◽  
Meconium Aspiration Syndrome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Meconium Aspiration ◽  
Lymphocyte Ratio ◽  
Meconium Stained Amniotic Fluid ◽  
Minute Apgar Score

AbstractMeconium aspiration syndrome (MAS) is a serious neonatal condition. Prediction of MAS is challenging particularly in low-resource setting. Neutrophil to lymphocyte ratio (NLR) is a new simple index used for diagnosis of many inflammatory conditions. The present study was an attempt to determine whether NLR can predict the occurrence of MAS. The present study included 101 children with meconium-stained amniotic fluid. They comprised 22 patients who developed MAS and 79 neonates who didn't have the condition. All neonates were subjected to careful analysis of maternal and perinatal history in addition to thorough clinical assessment and radiological and laboratory evaluation. Blood samples from the umbilical cord were collected at birth and were used to obtain complete blood counts and C-reactive protein (CRP) assay. Univariate analysis revealed that elevated CRP levels, increased NLR, and 5-minute Apgar score of <7 were significant risk factors for the occurrence of MAS. Multivariate analysis revealed that low 5-minute Apgar score and increased NLR remained as significant risk factors of MAS. Receiver operating characteristic curve analysis showed good performance of NLR in prediction of MAS. NLR is useful in prediction of MAS in term neonates with meconium-stained amniotic fluid.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

scholarly journals Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 420
Author(s):  
Claudia Ioana Borțea ◽  
Florina Stoica ◽  
Marioara Boia ◽  
Emil Radu Iacob ◽  
Mihai Dinu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Surfactant Administration ◽  
Stage 1

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

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