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Published on: November 20, 2015
Postnatal systemic inflammation and neuro-ophthalmologic dysfunctions in extremely low gestational age children
Mari Holm1, Dordi Austeng2,3, Raina N Fichorova4
1Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Insights
This study found no link between early systemic inflammation and later visual problems in very preterm infants. Neonatal inflammation markers did not predict visual field deficits, strabismus, or impaired fixation at age two.
Area of Science:
- Neonatal research
- Ophthalmology
- Immunology
Background:
- Infants born very preterm face higher risks for both visual impairments and systemic inflammation.
- Understanding potential links between these conditions is crucial for early intervention.
Purpose of the Study:
- To investigate the association between neonatal systemic inflammation and neuro-ophthalmologic dysfunctions in very preterm children.
- To determine if early inflammatory markers predict visual deficits at two years of age.
Main Methods:
- The study analyzed blood samples from 1062 very preterm infants (born before 28 weeks gestation) for 16 inflammatory mediators over the first four postnatal weeks.
- Visual functions (visual field deficit, strabismus, impaired fixation) were assessed at age two.
- Statistical analyses, including odds ratios adjusted for gestational age and birth weight, were performed to identify correlations.
Main Results:
- A significant association was found for only one of 80 inflammatory mediator assessments regarding visual field deficit and impaired fixation.
- No significant association was observed between strabismus and any measured inflammatory mediator.
- The majority of assessed inflammatory markers showed no correlation with the studied visual dysfunctions.
Conclusions:
- The study concludes that the assessed neuro-ophthalmologic dysfunctions at two years of age do not appear to be associated with systemic inflammation during the first four postnatal weeks.
- These findings suggest that early inflammation may not be a primary predictor for these specific visual problems in very preterm infants.
Aim:
Compared to infants born at term, children born very preterm are at increased risk of visual dysfunctions and neonatal systemic inflammation. Here, we explore whether these two propensities are related.
Methods:
As part of the ELGAN study, the concentrations of 16 mediators of inflammation were measured in blood obtained on postnatal days 1, 7, 14, 21 and 28 from 1062 children born before the 28th week of gestation. Presence of visual field deficit, strabismus and/or impaired visual fixation was recorded at age two. The concentrations of each protein were divided into quartiles within gestational week categories. We calculated odds ratios with 99% confidence intervals for having each disorder comparing children with concentration in the top quartile of each protein to children whose concentration was in the lower quartiles on the corresponding day. Analyses were adjusted for gestational age and birth weight Z-score.
Results:
Only one of 80 assessments (16 proteins on five different days) was significant for visual field deficit, and one for impaired fixation. No association was found between strabismus and any inflammatory mediator.
Conclusion:
None of the three neuro-ophthalmologic dysfunctions assessed at two years appears to be associated with systemic inflammation measured the first four postnatal weeks.
