INTRODUCTION
Low serum insulin-like growth factor 1 (IGF-1) has been associated with development of severe retinopathy of prematurity (ROP), but no U.S. studies have been reported. We sought to determine the relationship between postnatal serum IGF-1 levels and severe ROP in a racially diverse U.S. cohort.
METHODS
Prospective cohort study of 74 infants with birth weight (BW) <1251g and a known ROP outcome at 3 Philadelphia hospitals. Weekly postnatal filter-paper bloodspot IGF-1 assays) were measured through 42 weeks postmenstrual age (PMA).
RESULTS
The cohort included 20 Caucasian, 45 black, 2 Asian, and 9 other infants; median gestational age (GA) 27.6 weeks (range 23-33); median BW 975g (range 490-1250). During PMA weeks 28 to 33, mean IGF-1 was 20.0 ng/mL(SE 0.52) for no ROP (n=46), 18.0(0.49) for stage 1 or 2 (n=23), and 17.0(0.70) for stage 3 (n=5, 2 lasered) (p=0.003). Adjustment for BW and GA showed similar results.
CONCLUSION
Presence and timing of an association between low postnatal serum IGF and ROP in a racially diverse U.S. sample were found to be consistent with European cohorts. This association provides the pathophysiological basis for growth-based predictive models, which could improve efficiency of ROP screening.