Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants

Dani, Carlo; Coviello, Caterina; Panin, Fiorenza; Frosini, Saverio; Costa, Simonetta; Purcaro, Velia; Lepore, Domenico; Vento, Giovanni

doi:10.1186/s13052-021-01011-w

Cited by 21 publications

(21 citation statements)

References 38 publications

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“…Of 1,347 potentially relevant studies identified from the initial search after removing duplicates, 1,123 records were excluded after title and abstract screening. 222 full-text records were examined for eligibility and additional 5 records were identified from other sources (Dammann et al, 2009;Liu et al, 2012;Güran et al, 2013;Bas et al, 2018;Dani et al, 2021). Following detailed evaluation, 63 records were included for meta-analysis.…”

Section: Search Results and Description Of Studiesmentioning

confidence: 99%

Beyond Fetal Immunity: A Systematic Review and Meta-Analysis of the Association Between Antenatal Corticosteroids and Retinopathy of Prematurity

Zeng

Lei

et al. 2022

Front. Pharmacol.

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Background: Retinopathy of prematurity (ROP) is a major cause of childhood blindness. Antenatal corticosteroids (ACS) exposure is known to ameliorate the risk of and mortality of neonatal morbidities. However, the effect of ACS on ROP development is currently unknown. We conducted a meta-analysis with up-to-date evidence to assess the association between ACS exposure and the development of ROP in at-risk preterm infants.Methods: PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library were systematically searched from inception to May 2021, supplemented with manual search from reference lists. Studies with a control group reporting ROP rate in ACS-exposed infants were included. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated utilizing a random-effects model. The Newcastle-Ottawa Scale was used for assessment of risk of bias in the included studies. Meta-regressions were performed to explore the predictive role of confounders for between-study variance.Results: A total of 63 studies, involving 196,264 infants, were included. Meta-analysis showed ACS exposure was not associated with ROP occurrence (uOR 0.92, 95% CI 0.80–1.07; aOR 0.87, 95% CI 0.7–1.08). Results from extremely immature subgroups revealed significant reduced risks of ROP occurrence in ACS-exposed infants. ACS exposure was associated with significantly lower odds of ROP progression in adjusted analysis (aOR 0.48, 95% CI 0.26–0.89) instead of unadjusted analysis (uOR 0.86, 95% CI 0.68–1.08). Meta-regression showed birth weight and patent ductus arteriosus of the cohort were associated with ROP occurrence, sample size and study design strongly associated with ROP progression in ACS-exposed infants.Conclusion: ACS treatment may decrease, but not prevent, the severity of ROP. Findings from severe ROP should be interpreted with caution owing to limited studies and the possibility of false-positive results. Considering the particular benefits in extremely immature infants, we recommend routine usage of ACS in mothers with threatened delivery to this particular birth cohort to prevent ROP occurrence. Future studies adjusting for major confounders are warranted to mitigate risk of bias in such observational evidence.

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Section: Search Results and Description Of Studiesmentioning

confidence: 99%

Beyond Fetal Immunity: A Systematic Review and Meta-Analysis of the Association Between Antenatal Corticosteroids and Retinopathy of Prematurity

Zeng

Lei

et al. 2022

Front. Pharmacol.

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“…Obteve-se como correlação estatística significativa para o desenvolvimento da ROP, neste estudo, o uso de cateteres, incluindo-se o PICC, o que difere de outros estudos (9)(10) que reportam fatores de risco associados ao surgimento do problema, sendo um aspecto a ser investigado em outras coortes futuramente, pois o uso de cateteres venosos..centrais..e..mesmo..umbilicais..é..prática largamente adotada nas UTINs. Até o momento, estudos têm evidenciado taxas de complicações entre os cateteres venoso central umbilical e periféricos em recém-nascidos, (19)(20) entretanto, sem correlação com a ROP especificamente, conforme ficou demonstrado em nossos achados.…”

Section: Discussionunclassified

“…(7)(8) Encontram-se descritos como fatores de risco para o desenvolvimento da ROP: Apgar menor que 7, flutuação nos níveis de oxigênio nas primeiras semanas de vida, uso de oxigenioterapia, necessidade de ventilação mecânica, transfusão sanguínea, persistência do canal arterial, baixo peso da criança para a IG, asfixia perinatal, gestação múltipla, sepse e meningite. (7,(9)(10) Tem impacto na qualidade da visão ao longo da vida, podendo evoluir para cegueira, por isso a importância de a enfermagem, cuja maioria de cuidadores dos RNPT hospitalizados encontra-se nessa categoria profissional, estudá-la, preveni-la e tentar minimizar suas consequências o mais precocemente possível. Para que isso seja possível, recomenda-se conhecer esse fenômeno nas distintas realidades de cuidado em saúde aos RNPT.…”

Section: Abstract Introduçãounclassified

Comorbidades e procedimentos assistenciais correlatos ao desenvolvimento de retinopatia da prematuridade

Pastro¹,

Viera²,

Balieiro³

et al. 2021

Semin. Cienc. Biol. Saude

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Objetivo: descrever as principais comorbidades e os procedimentos assistenciais correlatos ao desenvolvimento de Retinopatia da Prematuridade em Recém-Nascidos Prematuros hospitalizados em Unidade de Terapia Intensiva Neonatal. Material e Método: estudo observacional quantitativo, com coleta de dados documental, obtida de 181 prontuários hospitalares de recém-nascidos prematuros, referente ao período de janeiro de 2014 a junho de 2016, em município de médio porte no Paraná. A análise estatística foi descritiva e inferencial. O estudo foi aprovado por comitê de ética em pesquisa. Resultados: Prevaleceu o diagnóstico doenças respiratórias (41,99%; p-valor < 0,109), seguido da comorbidade sepse (63,54%; p-valor < 0,357). Necessitaram de transfusão de sangue 80 bebês (44,20%; p-valor < 0,001), e 152 (83,98%; p-valor < 0,001) fizeram uso de oxigenioterapia. A retinopatia da prematuridade prevaleceu nos prematuros moderados (44%), sendo o grau 3 o mais grave encontrado. Conclusão: doenças respiratórias, sepse e procedimentos como a transfusão de sangue, a oxigenioterapia e a cateterização intravenosa influenciaram na presença do agravo, com maior incidência em prematuros moderados.

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“…In a more contemporary cohort, we have previously shown that those infants with no ROP had a higher intake of MOM (mL · kg −1 · day −1 ) compared with infants with any ROP ( 20 ). Dani et al ( 28 ) recently presented that increasing MOM intake reduced the risk of ROP development in an Italian cohort of very preterm infants. In our cohort, however, the proportional intake of PN seemed to attenuate the relationship observed between MOM and severe ROP.…”

Section: Discussionmentioning

confidence: 99%

Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population‐based Cohort of Extremely Preterm Infants

Lund

Domellöf

Pivodic

et al. 2021

J. pediatr. gastroenterol. nutr.

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Objectives: The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants. Methods: Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z -score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate the association between exposures and outcomes. Results: Infants’ mean gestational age (GA) was 25.4 weeks. Unadjusted, MOM (per 10 mL · kg −1 · day −1 ) was associated with Δweight and ΔHC with beta estimates of 0.03 z -score units (95% CI, 0.02–0.04, P < 0.001) and 0.03 z -score units (95% CI, 0.01–0.05, P = 0.003), respectively. After adjustment for predefined confounders, the association remained significant for Δweight and ΔHC. A similar pattern was found between Δweight and each 10% increase of MOM. Unadjusted, a higher intake of MOM (mL · kg −1 · day −1 ) was significantly associated to a lower probability of any ROP and severe ROP; however, these associations did not remain in the adjusted analyses. No associations were found between MOM (mL · kg −1 · day −1 ) and BPD. Moreover, no associations were found between DM and growth or morbidity outcomes. Conclusions: An increased intake of MOM, as opposed to DM (and not formula feeding), was associated with improved postnatal weight gain and HC growth from birth until 32 weeks PMA in extremely preterm infants. Interventions aiming at increasing early intake of unpasteurized MOM for extremely preterm infants should be encouraged.

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Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants

Cited by 21 publications

References 38 publications

Beyond Fetal Immunity: A Systematic Review and Meta-Analysis of the Association Between Antenatal Corticosteroids and Retinopathy of Prematurity

Beyond Fetal Immunity: A Systematic Review and Meta-Analysis of the Association Between Antenatal Corticosteroids and Retinopathy of Prematurity

Comorbidades e procedimentos assistenciais correlatos ao desenvolvimento de retinopatia da prematuridade

Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population‐based Cohort of Extremely Preterm Infants

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