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Published on: April 2, 2021
Early postnatal hyperglycaemia is a risk factor for treatment-demanding retinopathy of prematurity
Carina Slidsborg1, Louise Bering Jensen1, Steen Christian Rasmussen2
1Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Insights
Neonatal hyperglycemia in the first week of life is an independent risk factor for developing retinopathy of prematurity (ROP). This finding is crucial for understanding ROP development in premature infants.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Identifying early risk factors for ROP is critical for timely intervention.
- Neonatal hyperglycemia is a common metabolic disturbance in preterm infants.
Purpose of the Study:
- To investigate the association between neonatal hyperglycemia in the first postnatal week and the development of treatment-demanding ROP.
- To determine if hyperglycemia is an independent risk factor for ROP, adjusted for known risk factors.
Main Methods:
- Danish national retrospective case-control study (2003-2006) of premature infants.
- Linked data from three national registers using unique civil registration numbers.
- 106 cases of treatment-demanding ROP matched with 204 controls, considering gestational age, ROP status, and NICU.
- Multivariate logistic regression analysis adjusted for known risk factors (GA, SGA, multiple birth, male sex).
Main Results:
- No statistically significant difference in energy or protein intake between groups.
- Borderline significant difference in early postnatal weight gain (p=0.047).
- Statistically significant difference in hyperglycemic events (p<0.001) between cases and controls.
- Hyperglycemia was identified as a statistically independent risk factor (OR: 1.022; p=0.031).
Conclusions:
- An independent association exists between neonatal hyperglycemic events in the first postnatal week and the later development of treatment-demanding ROP.
- Neonatal hyperglycemia should be considered a potential risk factor for ROP.
- Further research may explore mechanisms linking hyperglycemia to ROP pathogenesis.
Background:
To investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP).
Methods:
This is a Danish national, retrospective, case-control study of premature infants (birth period 2003-2006). Three national registers were searched, and data were linked through a unique civil registration number. The study sample consisted of 106 cases each matched with two comparison infants. Matching criteria were gestational age (GA) at birth, ROP not registered and born at the same neonatal intensive care unit. Potential 'new' risk factors were analysed in a multivariate logistic regression model, while adjusted for previously recognised risk factors (ie, GA at birth, small for gestational age, multiple birth and male sex).
Results:
Hospital records of 310 preterm infants (106 treated; 204 comparison infants) were available. Nutrition in terms of energy (kcal/kg/week) and protein (g/kg/week) given to the preterm infants during the first postnatal week were statistically insignificant between the study groups (Mann-Whitney U test; p=0.165/p=0.163). Early postnatal weight gain between the two study groups was borderline significant (t-test; p=0.047). Hyperglycaemic events (indexed value) were statistically significantly different between the two study groups (Mann-Whitney U test; p<0.001). Hyperglycaemia was a statistically independent risk factor (OR: 1.022; 95% CI 1.002 to 1.042; p=0.031).
Conclusion:
An independent association was found between the occurrence of hyperglycaemic events during the first postnatal week and later development of treatment-demanding ROP, when adjusted for known risk factors.
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