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Published on: January 7, 2018
Poor postnatal weight gain: a risk factor for severe retinopathy of prematurity
D K Wallace1, J A Kylstra, S J Phillips
1Departments of Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7040, USA. dkwallac@med.unc.edu
Insights
Poor postnatal weight gain is a significant risk factor for severe retinopathy of prematurity (ROP) in premature infants. Monitoring weight gain is crucial for identifying infants at risk for severe ROP.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early identification of risk factors for severe ROP is critical for timely intervention.
- Postnatal growth patterns may influence ROP development.
Purpose of the Study:
- To investigate the association between the rate of postnatal weight gain and the severity of retinopathy of prematurity (ROP).
- To identify key risk factors contributing to ROP severity in preterm infants.
Main Methods:
- Retrospective review of records for 111 infants screened for ROP.
- Inclusion criteria: estimated gestational age ≤30 weeks and follow-up to 42 weeks' postconception.
- Statistical analysis including multivariate and stepwise regression to identify risk factors.
Main Results:
- Infants with severe ROP (stage 3+) had a higher average daily weight gain (10.9 g/kg) in the first 6 weeks compared to those with mild/no ROP (9.6 g/kg).
- Rate of postnatal weight gain was significantly associated with ROP severity (P = .02).
- Key predictors of ROP severity included gestational age, postnatal weight gain rate, erythrocyte transfusion volume, and sepsis.
Conclusions:
- Poor postnatal weight gain is identified as a risk factor for severe ROP (stage 3 or greater).
- Ophthalmologists should monitor infants gaining less than 50% of their birth weight in the first 6 weeks.
- This finding highlights the importance of nutritional support in preventing severe ROP.
Purpose:
This study aimed to investigate the relationship between rate of postnatal weight gain and severity of retinopathy of prematurity (ROP).
Methods:
All infants (n = 111) screened for ROP at a single tertiary intensive care nursery over a 2-year period with an estimated gestational age of 30 weeks or less and follow-up to at least 42 weeks' postconception were included. The authors performed a retrospective review of records and statistical analysis of risk factors for ROP using multivariate analysis.
Results:
Infants with severe (stage 3 or greater) ROP gained an average 10.9 g/kg per day in the first 6 weeks of life, compared to a mean of 9.6 g/kg per day for those with mild or no ROP (P =.04). By multiple regression, which included birth weight, gestational age, and 9 other reported risk factors, there was an association between rate of postnatal weight gain and severity of ROP (P =.02). By stepwise regression, 4 variables were associated with ROP severity: estimated gestational age at birth (P =.002), rate of postnatal weight gain (P = .0002), volume of transfused erythrocytes (P =.0001), and culture-proven sepsis (P = .02).
Conclusion:
Poor postnatal weight gain is a risk factor for the development of severe (stage 3 or greater) ROP. Ophthalmologists should take note of those infants who gain less than 50% of their birth weight in the first 6 weeks of life.
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