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Retinopathy of Prematurity and Glucose-6-Phosphate Dehydrogenase Activity: A Case-Control Study

Rajarajan Paulpandian1, Sourabh Dutta2, Reena Das3

  • 1Neonatology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Indian Journal of Pediatrics
|May 25, 2023
PubMed

Insights

Higher glucose-6-phosphate dehydrogenase (G6PD) activity in red blood cells is linked to retinopathy of prematurity (ROP) in premature infants. Increased G6PD levels elevate the risk of developing ROP.

Area of Science:

  • Neonatal Medicine
  • Biochemistry
  • Ophthalmology

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • The etiology of ROP is multifactorial, involving factors like prematurity, oxygen exposure, and birth weight.
  • Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme crucial for red blood cell function.

Purpose of the Study:

  • To investigate the association between red blood cell glucose-6-phosphate dehydrogenase (G6PD) activity and the occurrence of retinopathy of prematurity (ROP).
  • To determine if G6PD activity is an independent predictor of ROP in preterm infants.

Main Methods:

  • A case-control study was conducted in a Level-3 neonatal unit involving preterm infants (birth weight <2000g).
  • Sixty infants with ROP (cases) and sixty without ROP (controls) were enrolled, excluding transfusion recipients.
  • Quantitative assay of G6PD activity in red blood cells was performed as a candidate risk factor.

Main Results:

  • Infants with ROP exhibited higher median G6PD activity compared to controls.
  • G6PD activity showed a trend of increasing with ROP severity, being highest in ROP requiring treatment.
  • Multivariable logistic regression identified G6PD activity (Adjusted OR 1.14) and shorter gestation as independent predictors of ROP.

Conclusions:

  • Elevated red blood cell G6PD activity is independently associated with retinopathy of prematurity in preterm infants.
  • Each 1 U/g Hb increase in G6PD activity was associated with a 14% increased odds of ROP.
  • Severer forms of ROP correlate with higher G6PD activity levels, suggesting a potential role in ROP pathogenesis.
Abstract

Keywords:
Anti-oxidantGlucose-6-phosphate dehydrogenaseNeonatePrematurityRetinopathy

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