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Early postnatal weight gain as a predictor for the development of retinopathy of prematurity
Manoj Biniwale1, Angela Weiner2, Smeeta Sardesai1
1a Division of Neonatal Medicine , LAC + USC Medical Center and Children's Hospital Los Angeles, USC Keck School of Medicine , Los Angeles , CA , USA.
Insights
Early postnatal weight gain accurately predicts type 1 retinopathy of prematurity (ROP) requiring treatment in preterm infants. The WINROP tool identified 90% of affected infants, enabling earlier detection than standard screening.
Area of Science:
- Neonatal medicine
- Ophthalmology
- Predictive analytics in healthcare
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Early detection and treatment of ROP are crucial to prevent vision loss.
- Predictive models for ROP can improve screening efficiency and patient outcomes.
Purpose of the Study:
- To validate the WINROP (Weight, IGF-1, Neonatal retinopathy of prematurity) tool for predicting type 1 ROP requiring treatment.
- To assess the reliability of early postnatal weight gain as a predictor of ROP in a predominantly Hispanic US cohort.
- To determine if the WINROP tool can identify infants at risk for ROP earlier than traditional screening methods.
Main Methods:
- A retrospective cohort study included preterm infants (<32 weeks gestation, <1500g birth weight).
- Weekly infant weights were entered into the WINROP tool up to 36 weeks postmenstrual age.
- The tool generated risk indicators for ROP, which were compared against actual ROP diagnoses.
Main Results:
- The WINROP tool was applied to 492 infants.
- It detected 90% (80/89) of infants who developed type 1 ROP requiring treatment.
- Nine infants with type 1 ROP were initially classified as low risk by the tool.
Conclusions:
- Early postnatal weight gain, as assessed by the WINROP tool, is a reliable predictor of type 1 ROP requiring treatment.
- The tool demonstrated 90% sensitivity in identifying at-risk infants before 32 weeks gestation.
- WINROP facilitates earlier identification of ROP compared to scheduled screening protocols.
Objective:
The objective of this study is to validate the reliability of early postnatal weight gain as an accurate predictor of type 1 retinopathy of prematurity (ROP) requiring treatment in a large predominantly Hispanic US cohort with the use of an online tool called WINROP (weight, neonatal retinopathy of prematurity (IGF-1), neonatal retinopathy of prematurity).
Study Design:
Retrospective cohort study consisted of preterm infants <32 weeks gestation and birth weight <1500 g. Weekly weights to 36 weeks post-menstrual age or discharge if earlier were entered into the WINROP tool. This tool generated alarm and risk indicator for developing ROP. The infants with type 1 ROP requiring treatment as well as all stages of ROP were compared with the alarms and risks generated by WINROP tool.
Results:
A total of 492 infants were entered into the WINROP tool. The infants who developed type 1 ROP requiring treatment, the WINROP tool detected 80/89 (90%) at less than 32 weeks gestation. Nine infants developed type 1 ROP were classified as low risk and did not alarm.
Conclusions:
Postnatal weight gain alone, in predominantly Hispanic US population, predicted type 1 ROP requiring treatment before 32 weeks of gestation in infants with a sensitivity of 90%. The tool appeared to identify majority of affected infants much earlier than the scheduled screening.
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