Early Weight Gain Predicts Retinopathy in Preterm Infants: New, Simple, Efficient Approach to Screening

Hellström, Ann; Hård, Anna‐Lena; Engström, Eva; Niklasson, Aimon; Andersson, Eva; Smith, Lois E H; Löfqvist, Chatarina

doi:10.1542/peds.2008-2697

Cited by 236 publications

(250 citation statements)

References 36 publications

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“…Recently, clinical prediction models to early identify patients in risk of ROP were presented. WINROP [29][30][31] and PINT-ROP 32 were presented using postnatal longitudinal weight gain measurements. ROPScore, by the other hand, uses the BW and the weight measured at completed 6 weeks of life as weighted values in the final calculation of the score.…”

Section: Discussionmentioning

confidence: 99%

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Eckert

Filho

Maia

et al. 2011

Eye

108

102

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Aims This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP. Methods A prospective cohort of preterm infants with BWp1500 g and/or GAp32 weeks was studied. The score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. The score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions. Results The sample included 474 patients. The area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately. Conclusions ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. The scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP.

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Section: Discussionmentioning

confidence: 99%

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Eckert

Filho

Maia

et al. 2011

Eye

108

102

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“…9 Later it was shown that only serial weight measurement part of WINROP algorithm, excluding IGF-1 measurements, can also predict severe ROP requiring treatment with 100% sensitivity. 10 This algorithm was validated in a different cohort of infants in Sweden and USA. 11,15 The first three studies we have mentioned were focused on weight gain during the first 6 weeks of life.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Recent data suggest that one of the strongest predictors of ROP is poor weight gain during the first weeks of life. [7][8][9][10][11] In this prospective study, we aimed to evaluate relative weight gain by 2 weeks intervals up to 6 weeks after birth in order to predict the development of ROP requiring treatment among very low birth weight (VLBW) infants.…”

Section: Introductionmentioning

confidence: 99%

Adjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in VLBW infants

Aydemir

Sarikabadayi

Aydemir

et al. 2011

Eye

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Aim To analyze relative weight gain by 2-week intervals up to 6 weeks after birth in order to predict the development of retinopathy of prematurity (ROP) requiring treatment among very low birth weight (BW) infants. Methods A prospective study including infants with BW r1500 g born in a single tertiary intensive care unit over 1-year period was conducted. Body weight measurements were recorded weekly and relative weight gains (g/kg/day) were calculated. The main outcome was development of ROP requiring treatment. Results Mean BW and gestational age (GA) of the whole cohort were 1165±223 g and 29.3 ± 2.3 weeks, respectively. Relative weight gain at 2 weeks and 4 weeks postnatal age were significantly lower in infants with severe ROP (P ¼ 0.041 and P ¼ 0.017, respectively). Relative weight gain at 6 weeks was not different between groups. Infants with severe ROP gained 6.7±4 g/kg/day in the first 4 weeks of life, compared with 9.3±4.5 g/kg/day for those with mild or no ROP. After adjusted for BW and GA in logistic regression poor relative weight gain in the first 4 weeks was found to be related to severe ROP (P ¼ 0.015). When all the other risk factors significant for severe ROP were included in the logistic regression poor weight gain did not arise as an independent risk factor. Conclusion Poor postnatal weight gain in the first 4 weeks of life is the end result of several comorbidities rather than being an independent risk factor. Poor weight gain can be an additional predictor of severe ROP in very low BW infants.

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“…Its variable specificity and poor positive predictive value in studies (table) 98,100,[121][122][123][124][125][126] suggest that the algorithm should be used in addition to conventional screening guidelines. WINROP does not currently include infants with a gestational age at birth of more than 32 weeks.…”

Section: Classification and Screeningmentioning

confidence: 99%

Retinopathy of Prematurity

Stahl¹,

Hellström²,

Smith³

2016

Anti-Angiogenic Therapy in Ophthalmology

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The immature retinas of preterm newborns are susceptible to insults that disrupt neurovascular growth, which leads to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sightthreatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development.

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Early Weight Gain Predicts Retinopathy in Preterm Infants: New, Simple, Efficient Approach to Screening

Cited by 236 publications

References 36 publications

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Adjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in VLBW infants

Retinopathy of Prematurity

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