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The effect of ibuprofen and caffeine prophylaxis on retinopathy of prematurity
Varsha Bhatt-Mehta1, Robert E Schumacher2
1Department of Clinical Pharmacy, College of Pharmacy; Department of Pediatrics and Communicable Diseases, Michigan Medicine, University of Michigan.
Insights
Prophylactic caffeine and ibuprofen did not affect severe retinopathy of prematurity (ROP) in extremely low birth weight infants. Oxygen exposure at 28 days postnatal age or 36 weeks corrected gestational age was linked to ROP severity.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Pharmacology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Caffeine and ibuprofen have shown potential in modulating vascular endothelial growth factor, a key factor in ROP development.
Purpose of the Study:
- To investigate the effect of prophylactic caffeine and ibuprofen on the incidence of severe ROP in extremely low birth weight infants.
- To assess the association between oxygen exposure and ROP severity.
Main Methods:
- Retrospective cohort study of 109 extremely low birth weight infants.
- Assessed ROP incidence and severity in relation to caffeine and ibuprofen exposure.
- Analyzed the impact of oxygen exposure at 28 days postnatal age and 36 weeks corrected gestational age.
Main Results:
- No significant difference in caffeine or ibuprofen exposure was found between infants with severe ROP and those with mild-to-moderate ROP.
- Infants with severe ROP had significantly lower gestational age.
- Oxygen exposure at 28 days postnatal age and 36 weeks corrected gestational age was significantly associated with ROP severity.
Conclusions:
- Prophylactic caffeine and ibuprofen administration did not demonstrate a detectable effect on severe ROP incidence in this cohort.
- Oxygen exposure is a significant risk factor for ROP severity in extremely low birth weight infants.
Purpose:
To determine whether prophylactic caffeine and ibuprofen, which have been shown to have vascular endothelial growth factor-modulating properties in other contexts, have a detectable effect on the incidence of severe retinopathy of prematurity (ROP) when administered in extremely low birth weight infants during the first 48 hours of life.
Methods:
In this retrospective cohort study, the incidence and severity of ROP with respect to total exposure to caffeine and ibuprofen were assessed. The effect of oxygen exposure at 28 days' postnatal age (PNA) and 36 weeks' corrected gestational age (GA) was also studied.
Results:
A total of 109 infants were included; of these, complete data were available for 93 infants (87%), of whom 18 (19%) had severe ROP (ETROP type 1, or stage 3), and 75 (81%) had mild-to-moderate ROP at final diagnosis. Infants with severe ROP had lower GA (P = 0.0006). Total caffeine and ibuprofen exposure did not vary with severity of ROP (P = 0.86 caffeine; P = 0.57 ibuprofen). Presence of oxygen at 28 days' PNA (P = 0.01) or 36 weeks' corrected GA varied significantly with ROP severity (P = 0.0005).
Conclusions:
A relationship between prophylactic caffeine and ibuprofen exposure and severity of ROP could not be detected in our study cohort. Presence of oxygen at 28 days' PNA or 36 weeks' corrected GA was associated with ROP severity.
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