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Human milk reduces the risk of retinal detachment in extremely low-birthweight infants
Toshio Okamoto1, Masaru Shirai, Masayo Kokubo
1Department of Pediatrics, Asahikawa Kosei Hospital, Hokkaido, Japan.
Insights
Extremely low-birthweight infants fed more human milk showed reduced risk of retinopathy of prematurity-related retinal detachment. Human milk may contain protective factors against ROP-induced blindness.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Supplemental oxygen, a known ROP risk factor, does not fully prevent ROP-related visual impairment.
- Identifying risk factors for ROP progression to retinal detachment is crucial for extremely low-birthweight infants (ELBWI).
Purpose of the Study:
- To identify risk factors associated with the progression of retinopathy of prematurity to retinal detachment in ELBWI.
Main Methods:
- Retrospective review of medical records for 42 ELBWI admitted to a neonatal intensive care unit (April 1999-March 2004).
- Comparison of perinatal and postnatal variables between infants who developed retinal detachment and those who did not.
- Analysis focused on nutritional intake, specifically human milk consumption.
Main Results:
- Seven ELBWI (16.7%) developed retinal detachment, with two experiencing blindness.
- Infants without retinal detachment consumed significantly more human milk (67-83% of total intake) compared to those with retinal detachment (24-38%) between 5-7 weeks postnatal age.
- A notable difference in daily human milk intake was observed between the groups when gestational age at birth was matched.
Conclusions:
- Human milk intake appears to be a protective factor against ROP progression to retinal detachment in ELBWI.
- Beneficial factors within human milk may mitigate ROP severity.
- Further research into these factors could lead to strategies to prevent blindness in premature infants.
Background:
Retinopathy of prematurity (ROP) is a major cause of blindness in children. Because the use of oxygen is a known risk factor for development of ROP, supplemental oxygen is used carefully. However, it does not necessarily reduce the morbidity of ROP-induced blindness. The aim of the present study was to identify the possible risk factors for progression to retinal detachment, a most relevant cause of visual impairment, in extremely low-birthweight infants (ELBWI).
Methods:
The medical records of the 42 ELBWI who were admitted to the neonatal intensive care unit in Asahikawa Kosei Hospital from April 1999 to March 2004 were retrospectively reviewed. Seven infants (16.7% of the ELBWI) developed retinal detachment and two of them became blind. Perinatal and postnatal variables in these infants with retinal detachment were compared with those in infants without retinal detachment.
Results:
A striking difference in the daily intake of human milk was found between the infants with or without retinal detachment when their gestational ages at birth were matched. The infants without retinal detachment were fed more human milk (67-83% volume of total nutritional intake) as compared to those with retinal detachment (24-38% volume of total nutritional intake) at a specific postnatal period, 5-7 weeks postnatal age.
Conclusions:
Human milk may contain some beneficial factors to reduce the severity of ROP. Identifying these factors in human milk may contribute to development of a strategy to rescue premature infants from blindness.
