Duration of anaemia during the first week of life is an independent risk factor for retinopathy of prematurity

Abstract

Aim This study evaluated the correlation between retinopathy of prematurity (ROP), anaemia and blood transfusions in extremely preterm infants. Methods We included 227 infants born below 28 weeks of gestation at King Edward Memorial Hospital, Perth, Australia, from 2014–2016. Birth characteristics and risk factors for ROP were retrieved, and anaemia and severe anaemia were defined as a haemoglobins of <110 g/L and <80 g/L, respectively. Logistic regression was used for the analysis. Results Retinopathy of prematurity treatment was needed in 11% of cases and the mean number of blood transfusions (p < 0.01), and mean number of weeks of anaemia (p < 0.001) and of severe anaemia (p < 0.05), had positive associations with ROP cases warranting treatment. In the multivariate logistic regression analysis, the best-fit model of risk factors included anaemic days during first week of life, with an odds ratio (OR) of 1.46% and 95% confidence interval (CI) of 1.16–1.83 (p < 0.05), sepsis during the first 4 weeks of life (OR 3.14, 95% CI 1.10–9.00, p < 0.05) and days of ventilation (OR 1.03, 95% CI 1.01–1.06, p < 0.05). Conclusion The duration of anaemia during the first week of life was an independent risk factor for ROP warranting treatment and preventing early anaemia may decrease this risk.

The treatment and risk factors of retinopathy of prematurity in neonatal intensive care units

“…In recent years, with the development of neonatal medical technology, an increasing number of severe premature infants have survived, including cases of prematurity associated with in vitro fertilization (IVF), multiple births and infants with very low birth weight, very low gestational age, congenital dysplasia, immaturity, septicemia, severe infections and multiple surgeries after birth. The survival rates of extremely immature premature infants < 26 weeks and < 1000 g worldwide have continuously increased, and the incidence of ROP has been increasing in parallel [ 5 – 8 ].…”

What Is New about Transfusions for Preterm Infants? An Update

“…An underlying problem of the difficulty in unravelling the knot of 2 co-travelers, i.e., anemia and transfusion therapy, is especially tricky in observational studies [26]. New large observational studies [27, 28] have been designed to follow up suggestions dating from 1981 [29] of a link between anemia and retinopathy of prematurity and transfusion itself. However, as discussed above, these are confounded [26].…”

Highlights in this issue

“…he duration of anaemia during the first week of life is an independent risk factor for retinopathy of prematurity (ROP), according to a study by Lundgren et al. that evaluated 227 extremely preterm infants . ROP treatment was needed in 11% of the infants, and the mean number of blood transfusions and weeks with anaemia were positively associated with ROP.…”