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Erythropoietin is not a risk factor for severe retinopathy of prematurity among high risk preterm infants
Kim Chi T Bui1, Naomi Ellenhorn2, Afshan Abbasi3
1Department of Pediatrics, Kaiser Permanente Los Angeles, California, United States of America.
Insights
Recombinant Erythropoietin (rhEPO) use was not associated with severe retinopathy of prematurity (ROP) in preterm infants. Continued ophthalmology follow-up after NICU discharge is crucial for managing ROP.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Perinatal Research
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Key risk factors include early gestational age, low birth weight, and oxygen exposure.
- Conflicting data exists regarding recombinant Erythropoietin (rhEPO) and ROP risk.
Purpose of the Study:
- To investigate if rhEPO is an independent risk factor for severe ROP.
- Focus on preterm infants (23-32 weeks gestation, <1500g birth weight).
Main Methods:
- Retrospective cohort study of 1762 premature infants (2009-2014).
- Propensity score (PS) analysis with inverse probability of treatment weighting (IPTW) used.
- Examined association between rhEPO treatment and ROP requiring intervention.
Main Results:
- Incidence of treated ROP was 7.3%.
- PS analysis revealed no association between rhEPO and severe ROP (Stage 2+).
- No link found in the overall cohort or high-risk subgroup (23-28 weeks gestation).
Conclusions:
- rhEPO use is not associated with an increased risk of severe ROP.
- Emphasizes the critical need for post-discharge ophthalmology follow-up for ROP surveillance.
Background:
Retinopathy of prematurity (ROP) is a developmental retinal vaso-proliferative disease and a leading cause of blindness in children. Early gestational age, low birth weight and unregulated oxygen exposure are the main risk factors for the development of ROP. There are conflicting reports of a possible association between recombinant Erythropoietin (rhEPO) use and an increased risk for the development of ROP.
Objective:
To determine whether rhEPO is an independent risk factor for the development of severe ROP among preterm infants with a gestational age of 23 to 32 weeks and a birth weight <1500 g.
Methods:
We performed a retrospective study of risk factors for ROP on a cohort of 1762 premature infants born between 2009 and 2014, half of whom received rhEPO. To examine the association between treated ROP and rhEPO, a propensity score (PS) analysis was performed using the inverse probability of treatment weighted (IPTW) approach.
Results:
The incidence of treated ROP was 7.3% (129/1762). PS analysis did not show an association between rhEPO and severe ROP needing treatment or ROP stage 2 or higher, in either the whole population or in the subgroup of babies born at 23 to 28 weeks gestation, in whom the incidence of severe ROP was the highest. Of 117 patients treated for Type 1 or worsening stage 3 ROP, 17 were first diagnosed after NICU discharge.
Conclusion:
Our study showed no association between Erythropoietin use and severe ROP and highlights the importance of Ophthalmology follow up after hospital discharge.
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