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The relationship between inflammatory markers and retinopathy of prematurity in extremely premature infants
Fatma Merve Bektaş1, Emin Serbülent Güçlü2, Hüseyin Şimşek3
1Ophthalmology Clinic, Mersin City Training and Research Hospital, Mersin, Turkey. fmerveb@gmail.com.
Insights
Extremely premature infants with prolonged mechanical ventilation and low platelet counts are at higher risk for retinopathy of prematurity. Gestational age, platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio predict treatment needs.
Area of Science:
- Neonatology
- Ophthalmology
- Pediatric Critical Care
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early identification of risk factors for ROP is crucial for timely intervention.
Purpose of the Study:
- To investigate the association between blood parameters, clinical factors, and the development of ROP in extremely premature (EP) infants.
- To identify predictors for ROP development and treatment requirements.
Main Methods:
- Retrospective analysis of 153 extremely premature infants.
- Categorization into groups based on the presence of inflammatory diseases.
- Evaluation of complete blood count parameters, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, platelet-lymphocyte ratio (PLR), and platelet mass index.
- Analysis of blood parameters from the first week and first month postnatally.
Main Results:
- Longer duration of mechanical ventilation was the sole factor predicting ROP development in infants with inflammatory diseases.
- Lower gestational age (GA), higher NLR, and lower PLR were associated with ROP requiring treatment in this group.
- In infants without inflammatory diseases, mechanical ventilation duration and low platelet (PLT) levels predicted ROP development, but no treatment predictors were found.
Conclusions:
- Prolonged mechanical ventilation and low platelet counts increase vulnerability to ROP in EP infants.
- Gestational age, PLR, and NLR are significant predictive factors for ROP treatment necessity.
Purpose:
This study aimed to evaluate the relationships among blood parameters, clinical factors, and retinopathy of prematurity (ROP) in extremely premature (EP) infants.
Methods:
This retrospective study included 153 EP infants who were categorized into two groups based on the presence of inflammatory diseases such as necrotizing enterocolitis, neonatal sepsis, bronchopulmonary dysplasia, severe intraventricular hemorrhage, preeclampsia, and premature rupture of membranes. Complete blood count parameters, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, platelet-lymphocyte ratio (PLR), systemic inflammatory index, and platelet mass index were recorded during the first week and first month after birth. The study analyzed the impact of parameters obtained through blood tests during the first week and first month on the development of ROP and the requirement for treatment.
Results:
In this study, 96 infants were diagnosed with inflammatory diseases. After multivariate regression analyses, the duration of mechanical ventilation (p = 0.010) was found to be the only factor that led to ROP development. Moreover, lower gestational age (GA) (p = 0.006), higher NLR (p = 0.026), and lower PLR (p = 0.019) were observed in infants requiring treatment compared to infants with spontaneous resolution of ROP in this group. 57 infants did not have inflammatory diseases. Although the duration of mechanical ventilation (p = 0.041) and low levels of platelets (PLT) (p = 0.046) measured in the first month postnatally were significantly found to be associated with ROP developement, no parameter affecting the required treatment could be determined.
Conclusion:
EP infants with longer mechanical ventilation durations and lower PLT counts are vulnerable to ROP development. GA, PLR, and NLR are predictive factors for treatment.
