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Severe Retinopathy of Prematurity in Big Babies
1Ophthalmology, Dr. Behçet Uz Child Disease and Surgery Training and Research Hospital, Izmir, Turkey.
Insights
Severe retinopathy of prematurity (ROP) is less common in larger, older infants. These "big babies" showed lower rates of oxygen use, sepsis, and necrotizing enterocolitis (NEC) compared to smaller premature infants.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Public health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Traditionally, ROP management focuses on very premature infants with low birth weight (BW).
- This study investigates ROP in larger infants, defined as gestational age (GA) > 32 weeks and BW > 1500g.
Purpose of the Study:
- To evaluate the characteristics and outcomes of ROP treatment in larger infants (GA > 32 weeks, BW > 1500g).
- To compare these outcomes with those of smaller, typically premature infants treated for ROP.
- To identify potential factors influencing severe ROP development in larger infants.
Main Methods:
- Retrospective and cross-sectional analysis of infants treated for ROP between June 2015 and 2020.
- Categorization of infants into "big babies" (GA > 32 weeks, BW > 1500g) and a control group of smaller premature infants.
- Comparison of gestational age, birth weight, oxygen therapy duration, and incidence of sepsis and necrotizing enterocolitis (NEC).
Main Results:
- Out of 6581 ROP examinations, 109 infants were treated for ROP.
- Thirteen "big babies" (12%) were treated for ROP, with a mean GA of 33.58 weeks and BW of 1860.83g.
- Compared to the control group, "big babies" showed lower rates of sepsis (1 vs. 18) and NEC (1 vs. 12), with similar oxygen therapy durations.
Conclusions:
- Larger infants (GA > 32 weeks, BW > 1500g) treated for severe ROP exhibit lower rates of associated morbidities like sepsis and NEC.
- These findings suggest that factors beyond prematurity and low birth weight may play a crucial role in the development of severe ROP.
- Further research is warranted to explore these alternative factors in the pathogenesis of severe ROP in larger infants.
Background:
Evaluation of babies with gestational age (GA) over 32 weeks and with a birth weight (BW) over 1500 g, who underwent treatment for retinopathy of prematurity (ROP).
Materials And Methods:
The data of babies with ROP between June 2015 - 2020 were analyzed retrospectively and cross-sectionally. All infants treated for ROP were evaluated. Big babies who were older than 32 weeks GA with a BW higher than 1500 g were determined. Other treated premature infants formed the control group.
Results:
We retrospectively scanned 6581 patients who underwent ROP examination. Of these babies, 109 were treated for ROP. Thirteen babies (12%) who were treated for ROP were born over 32 weeks of GA and above the weight of 1500 g. One big infant was excluded because of missing file data. Eleven of these infants had type 1 ROP and 1 had aggressive posterior ROP. The mean GA and BW of big babies was 33.58 ± 0.88 weeks and 1860.83 ± 257.73 g, respectively. The mean GA and BW of the control group was 27.85 ± 2.02 weeks and 1068.28 ± 313.78 g, respectively. Both the big babies and the control group received oxygen treatment for 15.25 ± 11.44 and 19.17 ± 12.11 days (p = 0.29), respectively. Sepsis was seen in one big infant but 18 infants were observed to have sepsis in the control group. Similarly, one big infant had necrotizing enterocolitis (NEC), while in the control group, 12 infants had NEC.
Conclusions:
Total oxygen intake days, NEC, and sepsis rates were found to be relatively lower in big babies with severe ROP. This could suggest that other factors may have a greater effect on the development of severe ROP in big babies.
