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Do postnatal glucocorticoids and retinopathy of prematurity relate?

J Termote1, N E Schalij-Delfos, A R Donders

  • 1Department of Neonatology, Wilhelmina Children's Hospital, University of Utrecht,The Netherlands.

American Journal of Perinatology
|January 6, 2001
PubMed

Insights

Postnatal glucocorticoids like hydrocortisone did not increase the risk of retinopathy of prematurity (ROP) in preterm infants. However, prolonged hydrocortisone use in infants with ROP was linked to a higher risk of severe ROP.

Area of Science:

  • Neonatal Medicine
  • Ophthalmology
  • Pharmacology

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
  • Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants, often treated with postnatal glucocorticoids.
  • The potential association between postnatal glucocorticoid use and ROP incidence/severity requires further investigation.

Purpose of the Study:

  • To investigate the relationship between postnatal hydrocortisone use and the incidence and severity of ROP.
  • To assess the risk of ROP and severe ROP in preterm infants treated with hydrocortisone for BPD.

Main Methods:

  • Retrospective study comparing 161 preterm infants treated with hydrocortisone for BPD against 253 controls.
  • Data collected over a 4-year period.
  • Logistic regression analysis used to determine associations.

Main Results:

  • Overall ROP incidence was 62.7% in the hydrocortisone group vs. 21.3% in controls.
  • Severe ROP incidence was 5% in the treatment group vs. 0.4% in controls.
  • Postnatal hydrocortisone was not significantly associated with increased ROP risk (OR 1.387, p=0.272) or severe ROP risk (OR 4.112, p=0.16).
  • Prolonged hydrocortisone use in infants with ROP was associated with increased severe ROP risk (OR 1.02, p=0.03).

Conclusions:

  • Postnatal hydrocortisone therapy was not found to be an independent risk factor for developing ROP or severe ROP.
  • Prolonged use of hydrocortisone in infants already diagnosed with ROP may increase the risk of severe ROP.
  • Further research is warranted to clarify the nuanced relationship between glucocorticoids and ROP outcomes.

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