Chronic Placental Inflammation as a Risk Factor of Severe Retinopathy of Prematurity

Abstract

BackgroundChronic placental inflammation (CPI) has been implicated in the pathogenesis of diseases in premature infants, whereas retinopathy of prematurity (ROP) is a major complication primarily affecting preterm and very low-birth-weight (VLBW) infants. This study aims to investigate the association between CPI and ROP in VLBW infants.MethodsWe performed a retrospective review of clinical records of VLBW infants born between 2013 and 2016. Placental pathology findings including CPI cases were analyzed using logistic regression to study infants’ morbidities and other clinical characteristics.ResultsA total of 402 infants with a mean (standard deviation) gestational age of 28.5 (2.8) weeks and birth weight of 1,027.2 (304.4) g were included. The incidence of ROP was 24.1%. CPI was found in 90 infants (22.4%), among which 28.9% (26 of 90) developed ROP, and 21.1% (19 of 90) underwent laser photocoagulation. Lower gestational age, lower birth weight, longer duration of oxygen supply, and presence of CPI were associated with the development of ROP. After adjustment for gestational age, birth weight, sex, duration of oxygen supply, and other overlapping placental pathology, CPI was associated with the odds for type 1 ROP that required laser photocoagulation (adjusted odds ratio, 2.739; 95% confidence interval, 1.112 to 6.749; p = .029).ConclusionsCPI was associated with severe ROP requiring treatment with laser photocoagulation in VLBW infants.

Exercise prevents the adverse effects of maternal obesity on placental vascularization and fetal growth

“…Furthermore, chronic inflammation as a result of MO induces dysregulation of placental angiogenesis (Kim et al . ). On the other hand, exercise can suppress inflammation as a result of obesity (Antunes et al .…”

Cumulative evidence for association of sepsis and retinopathy of prematurity

“…Neonatal early onset sepsis is secondary to intrauterine infection in most cases, which may increase the risk for the development ROP. [56,57] Moreover, infants with intrauterine infection after birth always have a worse respiratory condition, which is typically treated with a higher concentration of oxygen and more advanced mechanical ventilation (such as invasive mechanical ventilation), which also increases the likelihood of ROP occurrence. [58,59] On the contrary, we found that the association of fungal sepsis with ROP was stronger than that of bacterial sepsis.…”

Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

“…In addition to oxygen administration [ 14 , 15 ], GA and BW represent major risk factors for ROP and are at the core of most ROP screening guides [ 16 , 17 ]. Studies on ROP physiopathology have suggested the possible implication of other factors, namely, maternal, such as preeclampsia and chorioamnionitis; prenatal; perinatal; demographic; genetic; and factors related to medical treatment and nutrition [ 16 , 18 ]. In a recent study, it has been demonstrated that prenatal steroid administration, GA, artificial ventilation, and respiratory distress syndrome (RDS) are correlated with ROP and bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular leukomalacia and the number of red cell concentrate transfusions are significantly correlated with ROP [ 2 ].…”