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Perinatal events predicting retinopathy of prematurity in extremely pre-term infants
Saif Aldeen AlRyalat1, Khaled Al Oweidat1, Ahmed Al-Amer1
1University of Jordan, Amman, Jordan.
Insights
Extremely preterm infants face risks for retinopathy of prematurity (ROP). This study identified key prenatal, perinatal, and postnatal factors, including infections and interventions, associated with ROP development in this vulnerable population.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Extremely preterm infants exhibit unique risks for retinopathy of prematurity (ROP).
- Understanding various insults is crucial for managing ROP in this population.
Purpose of the Study:
- To investigate prenatal, perinatal, and postnatal insults affecting extremely preterm infants.
- To determine the association of these insults with the development of retinopathy of prematurity (ROP).
Main Methods:
- Utilized data from the Prematurity and Respiratory Outcomes Program (PROP).
- Included infants with gestational age 23 0/7 to 28 6/7 weeks.
- Employed multiple regression analysis to assess stressful events and modifiable variables.
Main Results:
- Analyzed data from 751 extremely preterm infants.
- Identified significant associations between ROP and increased need for prophylactic indomethacin, air leaks, ventilator-associated pneumonia, bowel perforations, sepsis, other infections, and ventricular shunt.
- Found a significant negative correlation between ROP development and birth weight (p < 0.001).
Conclusions:
- This study examined the largest sample of extremely preterm infants with the most comprehensive set of factors studied.
- Recommended a screening program for extremely preterm infants incorporating a scoring system for complicated conditions.
Background:
Extremely preterm infants are peculiar in regard to their risk of retinopathy of prematurity (ROP). In this study, we aim to study insults that may affect extremely preterm infants, including prenatal, at birth, and postnatal insults and their effect on the development of ROP.
Methods:
This study used the data from Prematurity and Respiratory Outcomes Program (PROP). All included infants with a gestational age of 23 0/7 to 28 6/7 weeks using best obstetrical estimate. We included stressful events and/or modifiable variables that may affect the normal development. We used multiple regression analysis in our statistical analysis.
Results:
We included a total of 751 infants in our study. The mean birth weight for the included sample was 915.1 (±232.94) grams. 391 (52.1%) Infants were diagnosed with ROP. We found a significant negative correlation between ROP development and birth weight (p < 0.001), with a correlation coefficient of - 0.374. We found that the need for prophylactic indomethacin (OR 1.67), the occurrence of air leaks (OR: 2.35), ventilator-associated pneumonia (OR: 2.01), isolated bowel perforations (OR: 3.7), blood culture-proven sepsis (OR: 1.5), other infections (OR: 1.44), and receiving ventricular shunt (OR: 2.9) are significantly associated with the development of ROP.
Conclusions:
We believe this study included the largest number of factors studied in the largest sample of extremely premature infants. We recommend a screening program for extremely preterm infants that takes into account a scoring system with higher scores for complicated condition.
