scholarly journals Late Growth and Changes in Body Composition Influence Odds of Developing Retinopathy of Prematurity among Preterm Infants

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 78
Author(s):  
Ellen C. Ingolfsland ◽  
Jacob L. Haapala ◽  
Lauren A. Buckley ◽  
Ellen W. Demarath ◽  
Sixto F. Guiang ◽  
...  

Background: While postnatal growth in the first month of life is known to impact retinopathy of prematurity (ROP) risk, the impact of growth later in hospitalization, during critical times of retinal vascularization, remains unknown. The purpose of this study was to assess if postnatal growth and body composition during the second half of neonatal intensive care unit hospitalization were associated with severity of retinopathy of prematurity in very low birth weight preterm infants. Methods: Prospective observational pilot study of 83 infants born <32 weeks gestation and <1500 g, conducted at a Level IV neonatal intensive care unit. Body composition was measured during the second half of hospitalization. Infants were evaluated for retinopathy of prematurity. Logistic regression was performed. Results: Greater gains in fat mass, fat-free mass, and percent body fat from 32 to 37 weeks postmenstrual age and higher % body fat at term postmenstrual age were associated with decreased odds of ≥stage 2 retinopathy of prematurity (p < 0.05). Conclusions: Improved growth later in neonatal intensive care unit hospitalization and increased adiposity at term may reduce odds of severe retinopathy of prematurity.

2018 ◽  
Vol 103 (6) ◽  
pp. 619-621 ◽  
Author(s):  
J Edy Siswanto ◽  
Nani H Widodo ◽  
Pieter J J Sauer

BackgroundRetinopathy of prematurity (ROP) is a well-known complication in preterm infants. Data on the incidence of ROP in Indonesia, in relation to birth weight (BW) and gestational age (GA), are limited.ObjectiveTo report the incidence of ROP in one of the oldest and largest neonatal intensive care unit (NICU) in Indonesia.MethodsWe studied the incidence and severity of ROP in inborn infants with a BW of ≤1500 g and/or GA of ≤32 weeks, who were admitted to the NICU of Harapan Kita Women and Children Hospital, Jakarta. In addition, infants with a higher BW and GA, receiving more than 40% oxygen for a longer period, were screened.ResultsIn 2005–2015, 182 infants were born with a BW of <1000 g and 437 with a weight of 1000–1500 g. In the <1000 g group, 27 (46%) of the screened infants showed no ROP, 22 (37%) showed ROP 1–2 and 10 (17%) showed ROP 3–5. In the 1000–1500 g group, 172 (68%) were without ROP, 71 (28%) with ROP 1–2 and nine (4%) with ROP 3–5. Twenty-two (13%) of the 163 screened infants weighing 1500–2000 g showed ROP 1–2 and two (1.2%) had ROP 3–5. Eight (18%) of the 44 screened infants born with a BW of more than 2000 g showed ROP 1–2 and none showed ROP 3–5.ConclusionThe total incidence of ROP as well as severe ROP in infants with a BW of <1000 g and 1000–1500 g in our NICU is higher than in a developed country. ROP in Indonesia is also seen in infants with a BW of 1500–2500 g. Increasing the awareness of the risks of oxygen as well as better equipment to monitor oxygen delivery is essential.


2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alice Hoffsten ◽  
Laszlo Markasz ◽  
Katharina Ericson ◽  
Leif D. Nelin ◽  
Richard Sindelar

AbstractReliable data on causes of death (COD) in preterm infants are needed to assess perinatal care and current clinical guidelines. In this retrospective observational analysis of all deceased preterm infants born < 37 weeks’ gestational age (n = 278) at a Swedish tertiary neonatal intensive care unit, we compared preliminary COD from Medical Death Certificates with autopsy defined COD (2002–2018), and assessed changes in COD between two periods (period 1:2002–2009 vs. period 2:2011–2018; 2010 excluded due to centralized care and seasonal variation in COD). Autopsy was performed in 73% of all cases and was more than twice as high compared to national infant autopsy rates (33%). Autopsy revised or confirmed a suspected preliminary COD in 34.9% of the cases (23.6% and 11.3%, respectively). Necrotizing enterocolitis (NEC) as COD increased between Period 1 and 2 (5% vs. 26%). The autopsy rate did not change between the two study periods (75% vs. 71%). We conclude that autopsy determined the final COD in a third of cases, while the incidence of NEC as COD increased markedly during the study period. Since there is a high risk to determine COD incorrectly based on clinical findings in preterm infants, autopsy remains a valuable method to obtain reliable COD.


2009 ◽  
Vol 5 (4) ◽  
pp. 304-307 ◽  
Author(s):  
Li Liu ◽  
Tian Tian ◽  
Chong-Xun Zheng ◽  
Vatavu Ileana ◽  
Anca Ioana ◽  
...  

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