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Published on: August 6, 2021
Association between retinal neovascularization and serial weight measurements in murine and human newborns
Sophie Vanhaesebrouck1, Hans Daniëls, Karel Allegaert
1Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium. sophie.vanhaesebrouck@uzleuven.be
Insights
Poor weight gain in newborns is a significant predictor of retinopathy of prematurity (ROP), a leading cause of preventable blindness. Early postnatal weight monitoring can help identify infants at risk for this serious condition.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Biology
Background:
- Retinopathy of prematurity (ROP) is a major cause of preventable blindness globally.
- While oxygen use and gestational age are known risk factors, the role of early postnatal weight gain remains a key area of investigation.
- Emerging evidence highlights poor weight gain as a strong predictor of ROP development.
Purpose of the Study:
- To determine the predictive value of serial weight measurements for neovascularization (NV) in retinopathy of prematurity (ROP).
- To analyze the relationship between early postnatal weight gain patterns and the development of retinal NV.
- To validate findings using both murine and human study models.
Main Methods:
- A prospective study involving serial weight measurements and area under the curve (AUC) calculations.
- Analysis of weight gain data using the nonparametric Mann-Whitney U test.
- Utilized an oxygen-induced retinopathy (OIR) model in mice and data from the NIRTURE trial in human infants.
Main Results:
- Significantly lower AUC of serial weight gain measurements was observed in murine and human newborns who developed retinal NV.
- Murine newborns developing NV showed lower weight gain (14 vs 17 g; p = 0.01).
- Human newborns developing NV had substantially lower weight gain (140 g/wk vs 240 g/wk; p = 0.0001).
Conclusions:
- Early postnatal weight gain is a critical indicator for the development of neovascular disease, specifically ROP.
- The study confirms previous findings on the importance of weight gain in ROP prediction.
- Novel statistical analysis supports the role of early weight gain monitoring in identifying at-risk infants.
Introduction:
Retinopathy of prematurity (ROP) is a leading cause of preventable blindness throughout the world. Several risk factors have been studied, but most studies remain inconclusive. Evidence is accumulating that one of the strongest predictors of ROP, in addition to oxygen use and low gestational age, is poor weight gain during the first postnatal weeks.
Methods:
In a prospective study, we sought to determine the importance of serial weight measurements to help predict neovascularization (NV). In a first stage, a summary of the response in each case is identified and calculated as area under the curve (AUC). In a second stage, these different AUCs are analyzed by nonparametric Mann-Whitney U test. For the murine study, pups were redistributed in smaller and larger litters. On postnatal day (P)7-12, the oxygen-induced retinopathy (OIR) model was applied. Body weight was measured on P7, P14, and P17. Retinal NV was assessed on P17. For the human study, the subjects were part of the control arm of the NIRTURE trial. Ophthalmologists screened for ROP. Birthweight was recorded. Weekly weight measurements were performed for the first 4 weeks.
Results:
The AUC of serial weight (gain) measurements was significantly lower in murine (14 vs 17 g; p = 0.01) and human (140 g/wk vs 240 g/wk; p = 0.0001) newborns developing retinal NV.
Conclusion:
This prospective study supports previous findings, using a new way of statistical analysis, that early postnatal weight gain is an important indicator in the development of neovascular disease.
