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Perinatal growth characteristics and associated risk of developing threshold retinopathy of prematurity
Karel Allegaert1, Christine Vanhole, Ingele Casteels
1Neonatal Intensive Care Unit, Department of Pediatrics, University Hospitals, Leuven, Belgium.
Insights
Infants who are small for gestational age (SGA) or have restricted growth are at higher risk for threshold retinopathy of prematurity (ROP). Postnatal weight gain is a factor, but birth size is the primary predictor of ROP risk.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Identifying risk factors for threshold ROP is crucial for timely intervention and prevention of vision loss.
Purpose of the Study:
- To investigate prenatal and postnatal growth characteristics as risk factors for developing threshold retinopathy of prematurity (ROP).
- To analyze the association between birth weight, weight gain, and the incidence of threshold ROP.
Main Methods:
- A case-control study comparing infants with threshold ROP to infants without ROP, matched for gestational age.
- Documented birth weight and absolute/relative weight gain in the first 6 weeks of life.
Main Results:
- Infants small for gestational age (SGA) and those with growth restriction (<25th percentile) had a significantly higher risk of threshold ROP.
- Absolute weight gain (g/d) was associated with increased ROP risk, while relative weight gain (g/kg/d) was not significantly different between groups.
Conclusions:
- Birth weight below the 25th percentile and SGA are confirmed risk factors for threshold ROP.
- While postnatal weight gain is statistically significant, birth size remains the most critical factor; growth-restricted infants remain at higher risk even with normal relative weight gain.
Purpose:
To document perinatal growth characteristics in infants who developed threshold retinopathy of prematurity (ROP) in an attempt to describe prenatal and postnatal growth-related risk factors for threshold ROP.
Methods:
To document birth weight as well as absolute and relative weight gain (g/d and g/kg/d) in the first 6 weeks of life in infants who developed threshold ROP and who were admitted to a single tertiary neonatal intensive care unit between 1996 and 2000. These data were compared (case-control approach) with infants of the same gestational age (GA) who did not developed threshold ROP.
Results:
Small for gestational age (SGA; ie, weight <10th percentile for a given GA) and growth restriction (<25th percentile for a given GA) are risk factors for threshold ROP (relative risk = 3.7 and 4.5, respectively). Absolute weight gain (g/d) is also associated with an increased risk of developing threshold ROP (P<.05). In contrast, relative weight gain (g/kg/d) is not significantly different between threshold ROP infants and GA-matched controls.
Conclusions:
SGA and a birth weight below the 25(th) percentile are risk factors for threshold ROP. Postnatal weight and absolute weight gain (g and g/d, respectively) in the first 6 weeks of life are statistically significant but of less clinical relevance because smaller infants at birth stay relatively smaller during the first 6 weeks of life. Even with normal (ie, same weight as control infants) postnatal relative weight gain (g/kg/d), growth retarded or restricted infants at birth still have an increased risk of developing threshold ROP.