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Published on: November 20, 2015
Retinopathy of prematurity and brain damage in the very preterm newborn
Elizabeth N Allred1, Antonio Capone2, Anthony Fraioli3
1Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Insights
Very preterm infants with severe retinopathy of prematurity (ROP) face higher risks of developmental delays. However, common risk factors, not anesthesia, explain most of this increased risk in brain function.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Ophthalmology
Background:
- Retinopathy of prematurity (ROP) is a significant concern in very preterm infants.
- ROP is associated with potential long-term neurodevelopmental challenges.
- Understanding the link between ROP and brain development is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between retinopathy of prematurity (ROP) and brain abnormalities in very preterm newborns.
- To determine the extent to which common risk factors explain the observed associations.
- To assess the role of anesthetic exposure in ROP-related neurodevelopmental outcomes.
Main Methods:
- Retinal examinations and developmental assessments (Bayley Scales) at 2 years corrected age were conducted on 1,085 infants born <28 weeks' gestation.
- Logistic regression models were used to analyze relationships between ROP severity and brain abnormalities, adjusting for confounders.
- Specific focus on prethreshold ROP and its association with developmental scores and anesthetic exposure.
Main Results:
- Severe ROP was linked to a higher likelihood of brain ultrasound lesions and cerebral palsy.
- Infants with severe ROP were twice as likely to have very low Bayley Scales scores.
- After adjusting for shared risk factors, severe ROP remained associated with increased risk of low Bayley Scales, but not brain lesions or cerebral palsy. Anesthesia exposure was not linked to poor outcomes in prethreshold ROP.
Conclusions:
- Common risk factors partially explain the association between ROP and brain disorders.
- The increased risk of very low Bayley Scales in infants with ROP is largely independent of anesthetic exposure.
- Further research is needed to fully elucidate the complex interplay between ROP and neurodevelopmental outcomes.
Purpose:
To explain why very preterm newborns who develop retinopathy of prematurity (ROP) appear to be at increased risk of abnormalities of both brain structure and function.
Methods:
A total of 1,085 children born at <28 weeks' gestation had clinically indicated retinal examinations and had a developmental assessment at 2 years corrected age. Relationships between ROP categories and brain abnormalities were explored using logistic regression models with adjustment for potential confounders.
Results:
The 173 children who had severe ROP, defined as prethreshold ROP (n = 146) or worse (n = 27) were somewhat more likely than their peers without ROP to have brain ultrasound lesions or cerebral palsy. They were approximately twice as likely to have very low Bayley Scales scores. After adjusting for risk factors common to both ROP and brain disorders, infants who developed severe ROP were at increased risk of low Bayley Scales only. Among children with prethreshold ROP, exposure to anesthesia was not associated with low Bayley Scales.
Conclusions:
Some but not all of the association of ROP with brain disorders can be explained by common risk factors. Most of the increased risks of very low Bayley Scales associated with ROP are probably not a consequence of exposure to anesthetic agents.
