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From Blood Count Parameters to ROP Risk: Early Hematological Predictors in Preterm Infants
Laura Bujoreanu Bezman1,2, Carmen Tiutiuca2,3, Florin Ciprian Bujoreanu2
1Department of Ophthalmology, "Sf. Ioan" Emergency Clinical Hospital for Children, 800487 Galati, Romania.
Insights
Anemia and thrombocytopenia in preterm infants, along with blood transfusions, are linked to a higher risk of retinopathy of prematurity (ROP). Monitoring these hematological markers can improve early ROP detection and prevention strategies.
Area of Science:
- Neonatology
- Ophthalmology
- Hematology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness.
- Hematological markers are emerging as key indicators for predicting ROP risk.
- Early detection and intervention are crucial for mitigating visual impairment in ROP.
Purpose of the Study:
- To investigate the association between hemoglobin levels, red blood cell count, platelet count, and blood transfusions with the risk of developing ROP.
- To identify novel prognostic factors for ROP in preterm infants.
- To refine ROP risk prediction models using hematological parameters.
Main Methods:
- Retrospective study of 140 preterm infants (gestational age ≤ 34 weeks).
- Sequential monitoring of hematological parameters during the first 28 days of life.
- ROP screening conducted per international guidelines; statistical analyses performed.
Main Results:
- Anemia was significantly more prevalent in infants with ROP (83.1% vs. 60.3%), increasing ROP risk (OR = 3.239).
- Red blood cell and platelet transfusions were associated with higher ROP likelihood (OR = 3.088 and OR = 2.807, respectively).
- Thrombocytopenia was linked to an elevated ROP risk (OR = 3.542), with lower platelet counts observed on days 7, 14, and 21 in the ROP group.
Conclusions:
- Early hematological imbalances, including anemia and thrombocytopenia, significantly increase ROP risk.
- The need for blood product transfusions is also a significant risk factor for ROP.
- Integrating hematological marker monitoring into ROP screening protocols can enhance early identification and targeted management of vulnerable infants.
Abstract:
Background and Objectives: Retinopathy of prematurity (ROP) persists as a major global cause of preventable childhood blindness. While early diagnosis and timely intervention can significantly mitigate visual loss, research is increasingly focused on identifying novel prognostic factors, with hematological markers emerging as a promising avenue for refining ROP risk prediction. This study aimed to assess the association of hemoglobin levels, red blood cell count, platelet count, and blood transfusions with the risk of developing ROP. Materials and Methods: We conducted a retrospective study involving 140 preterm infants (gestational age ≤ 34 weeks) admitted to a neonatal intensive care unit between 2021 and 2024. Hematological parameters were monitored sequentially during the first 28 days of life, and ROP screening was performed in accordance with international guidelines. Statistical analyses evaluated associations between hematological markers and the risk of developing ROP. Results: Anemia prevalence was significantly higher in infants who developed ROP (83.1%) compared with those who did not (60.3%), conferring an increased risk of ROP (OR = 3.239; p = 0.001). Red blood cell transfusions were linked to a higher likelihood of developing ROP (OR = 3.088; p = 0.001), while platelet transfusions showed a similar association (OR = 2.807; p = 0.027). Platelet counts were significantly lower on days 7, 14, and 21 in the ROP group, and thrombocytopenia was associated with an elevated risk of disease (OR = 3.542; p = 0.001). Conclusions: Early hematological imbalances (anemia, thrombocytopenia) and the requirement for blood product transfusions are significantly associated with an increased risk of ROP. Integrating the monitoring of these specific parameters into existing ROP screening protocols could enhance early identification of vulnerable preterm infants, enabling more targeted surveillance and potential preventative strategies.
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