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Predictive Value of Postnatal Weight Gain Rate for Severe Retinopathy of Prematurity in Preterm Infants: A
Jiangya Wang1, Qingmin Ma2, Fangfang Du1
1Department of Pediatrics, Hebei General Hospital, Shijiazhuang, 050000, People's Republic of China.
Insights
Lower postnatal weight gain rate (WGR) is a significant risk factor for retinopathy of prematurity (ROP) in preterm infants. A WGR below 18 g/day may predict severe ROP, aiding early intervention.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Pediatric critical care
Background:
- Retinopathy of prematurity (ROP) incidence is increasing in China.
- Current ROP screening methods (gestational age, birth weight) have limitations.
- Postnatal weight gain rate (WGR) shows potential as a predictive marker for ROP.
Purpose of the Study:
- To investigate risk factors for ROP incidence in preterm infants.
- To evaluate the predictive value of WGR for ROP, especially severe ROP.
- To establish WGR thresholds for ROP prediction in the Chinese population.
Main Methods:
- Retrospective cohort study of 230 preterm infants (GA ≤32 weeks, BW ≤2000g).
- Analysis of clinical data including gestational age (GA), birth weight (BW), and WGR.
- Multivariate logistic regression and ROC curve analysis to identify risk factors and predictive values.
Main Results:
- Lower GA, BW, and WGR were independent risk factors for ROP.
- WGR <24.5 g/day predicted any ROP with high sensitivity and specificity (AUC=0.939).
- WGR <18 g/day predicted severe ROP with 100% sensitivity (AUC=0.865).
Conclusions:
- Diminished GA, BW, and WGR increase ROP susceptibility.
- Sluggish WGR is a crucial indicator for severe ROP risk.
- WGR thresholds can aid in early detection and management of ROP.
Background:
Retinopathy of prematurity (ROP) is rising in China alongside improved neonatal intensive care. Current screening, reliant on gestational age (GA) and birth weight (BW), faces challenges of resource constraints and infant burden. Postnatal weight gain rate (WGR) is a potential predictive marker, but robust data on its value, particularly for severe ROP, and validated thresholds within the Chinese population are lacking. The study aimed to examine the risk factors linked with the incidence of retinopathy of ROP.
Methods:
A retrospective cohort analysis was conducted on 230 preterm infants (GA ≤32 weeks, BW ≤2000g) admitted to a neonatal intensive care unit (2016-2020). Infants were categorized into non-ROP (n=189) and ROP (n=41) groups; the ROP group was further stratified into mild (n=32) and severe (n=9) subgroups. Clinical data, including GA, BW, comorbidities and WGR, were analyzed. Univariate analysis, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were employed.
Results:
In the univariate analysis, the non-ROP group manifested superior values in GA, BW, and rates of weight gain in comparison to the ROP group (all P < 0.05). Multivariate analysis identified lower GA (OR=0.91, 95% CI=0.83-0.99, P=0.03), lower BW (OR=0.99, 95% CI=0.99-1.00, P=0.04), and lower WGR (OR=0.73, 95% CI=0.63-0.83, P<0.01) as independent risk factors for ROP. GA, BW, and WGR were significantly higher in the mild vs severe ROP group (all P<0.05). ROC analysis demonstrated that WGR <24.5 g/day predicted any ROP (AUC=0.939, 95% CI=0.905-0.973, sensitivity 90.2%, specificity 86.8%, P<0.05). Crucially, WGR <18 g/day predicted severe ROP (AUC=0.865, 95% CI=0.70-1.00, sensitivity 100%, specificity 66,7%, P<0.05).
Conclusion:
Diminished GA, reduced BW, and sluggish weight gain rates have been correlated with an elevated susceptibility to ROP. Notably, a diminished rate of weight gain can serve as an anticipatory marker for severe ROP, given its heightened propensity to precipitate the onset of severe ROP.
Trial Registration:
Full name of the registry: Chinese Clinical Trial Registry, http://www.chictr.org.cn. Trial registration number: chiCTR2400087938. Date of registration: 2024-08-07.
