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Perinatal infection, inflammation, and retinopathy of prematurity

Jennifer Lee1, Olaf Dammann

  • 1Division of Newborn Medicine, Box 44, Floating Hospital for Children at Tufts Medical Center, 800 Washington St, Boston, MA 02111-1526, USA. jlee9@tuftsmedicalcenter.org

Seminars in Fetal & Neonatal Medicine
|September 10, 2011
PubMed

Insights

Perinatal infection and inflammation increase the risk of retinopathy of prematurity (ROP) in premature infants. Targeting inflammation may help prevent ROP by sensitizing the retina to oxygen-related damage.

Area of Science:

  • Neonatal ophthalmology
  • Perinatal medicine
  • Inflammatory disease research

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of vision impairment in premature infants.
  • Established risk factors include extremely low gestational age and oxygen exposure (phases I and II).
  • Emerging evidence links perinatal infection/inflammation to increased ROP risk.

Purpose of the Study:

  • To review current data on the association between perinatal infection/inflammation and ROP.
  • To explore potential mechanisms linking inflammation to ROP pathogenesis.
  • To highlight the role of inflammation as a potential 'pre-phase' in ROP development.

Main Methods:

  • Literature review of recent studies on ROP risk factors.
  • Analysis of proposed pathophysiological pathways involving infection, inflammation, and oxidative stress.
  • Synthesis of evidence supporting a multi-stage model of ROP development.

Main Results:

  • Perinatal infection/inflammation is associated with a higher risk of developing ROP.
  • Inflammation may directly affect the developing retina or modify oxygen-induced damage.
  • Systemic inflammation (prenatal, perinatal, postnatal) may sensitize the retina, creating a 'pre-phase' for ROP.

Conclusions:

  • Inflammation plays a crucial role in ROP pathogenesis, potentially acting as a sensitizing 'pre-phase'.
  • Understanding these inflammatory mechanisms is key to developing new preventative strategies.
  • Targeting inflammatory responses could reduce ROP incidence in extremely low gestational age newborns.

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