Preeclampsia and Retinopathy of Prematurity in Preterm Births

Yu, Xiaoli; Dw, Branch; Sa, Karumanchi; J, Zhang

doi:10.1542/peds.2011-3881

Cited by 53 publications

(63 citation statements)

References 39 publications

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“…If being SGA is both caused by hypertension/preeclampsia and associated with ROP, then adjusting for birth weight in studies analyzing the role of hypertensive disorders could give rise to a problem of "overadjustment." In fact, studies that investigate the role played by hypertension on ROP and correct-for-birth weight in their analysis find that hypertension is protective, [28][29][30] whereas others that do not adjust (eg, this study and refs 14,27,28) find the opposite.…”

Section: Figurementioning

confidence: 69%

“…In addition, it shows how for in-hospital mortality the relationship between the relative exposures and the outcome is not constant, even in the small GA strata considered in this study (23)(24)(25)(26)(27)(28)(29)(30) weeks' GA).…”

Section: Discussionmentioning

confidence: 80%

“…[29][30][31] A possible explanation for these discordant results lies in the data analysis. It is known that SGA infants (a condition the risk for which is increased by hypertension) 23 have a higher frequency of ROP.…”

Section: Figurementioning

confidence: 99%

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Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: In very preterm infants, outcomes depend not only on the degree of immaturity, but also on the underlying pathologies that trigger preterm delivery. Studies that have addressed this issue have provided unclear results.WHAT THIS STUDY ADDS: Patterns of outcomes differ between maternal hypertension and chorioamnionitis: hypertension is associated with greater risks for bronchopulmonary dysplasia and retinopathy of prematurity, and lower risks for brain injury, necrotizing enterocolitis, early-onset sepsis. For mortality, the effect changes across gestational age weeks. abstract OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS:A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS:Overall mortality was higher after hypertension than after chorioamnionitis (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.08-1.80), but this relationship changed across GA weeks; the OR for hypertension was highest at low GA, whereas from 28 weeks' GA onward, mortality was higher for chorioamnionitis. For other outcomes, the relative risks were constant across GA; infants born after hypertension had an increased risk for bronchopulmonary dysplasia (OR, 2.20; 95% CI, 1.68-2.88) and severe retinopathy of prematurity (OR, 1.48; 95% CI, 1.02-2.15), whereas there was a lower risk for earlyonset sepsis (OR, 0.25; 95% CI,, severe intraventricular hemorrhage (OR, 0.65; 95% CI, periventricular leukomalacia (OR, 0.70; 95% CI,, and surgical necrotizing enterocolitis or gastrointestinal perforation (OR, 0.47; 95% CI, 0.31-0.72).CONCLUSIONS: Mortality and other adverse outcomes in very preterm infants depend on antecedents of preterm birth. Hypertension and chorioamnionitis are associated with different patterns of outcomes; for mortality, the effect changes across GA weeks. Pediatrics 2014;134:e154-e161 AUTHORS:

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Section: Figurementioning

confidence: 69%

Section: Discussionmentioning

confidence: 80%

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Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

et al. 2014

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“…A negative correlation between ROP and PET has been described. [23] The association of delivery via caesarean section and a decreased prevalence of ROP may be a chance one. The small numbers in our study precluded further analysis.…”

Section: Discussionmentioning

confidence: 99%

Retinopathy of prematurity in a cohort of neonates at Groote Schuur Hospital, Cape Town, South Africa

et al. 2016

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Background. Severe retinopathy of prematurity (ROP) can cause blindness. Before 2016, resource limitations precluded routine screening for ROP at Groote Schuur Hospital (GSH), Cape Town, South Africa. Previous pilot studies at GSH found no patients with ROP requiring treatment; however, improved preterm infant survival may affect the prevalence. Objectives. To determine the prevalence and severity of ROP, describe potential risk factors, and assess the feasibility of ROP screening. Methods. Infants with a birth weight (BW) of <1 251 g or a gestational age (GA) of ≤31 weeks were screened from November 2012 to May 2013. Results. Three hundred and thirteen ROP examinations were performed in 135 of 191 eligible infants. The mean GA and BW were 30.1 weeks (standard deviation (SD) 1.9) and 1 056 g (SD 172), respectively. ROP was diagnosed in 40 infants (29.6%); 8 (5.9%) had severe ROP and 2 (1.5%) received laser treatment. Infants with ROP had a lower mean GA (29.2 weeks (SD 1.6) v. 30.5 weeks (SD 1.9)) (p<0.002) and a lower mean BW (988 g (SD 181) v. 1 085 g (SD 160)) (p=0.001) than those without ROP. Infants weighing <1 000 g had a 2.5 times higher risk than those with a BW of ≥1 000 g of having ROP (95% confidence interval 1. 05 -5.90; p=0.03). Blood transfusions (p<0.002) and late-onset sepsis (p=0.024) were strongly associated with ROP. Screening was completed in 91.1% (123/135) of the infants. Conclusions. The prevalence and severity of ROP have increased at GSH. The strong association between ROP, BW and GA suggests that infants with lower BWs and GAs should be prioritised for screening in our resource-limited setting.

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“…Preeclampsia-induced vascular dysfunction may have other clinical consequences in offspring, such as an increased risk of hypertension (Seidman et al 1991;Vatten et al 2003) and stroke (Kajantie et al 2009). Interestingly, the antiangiogenic state of gestational hypertension/preeclampsia protects the infant from retinopathy of prematurity (Yu et al 2012), a disorder characterized by the overproduction of VEGF (Pierce et al 1995;Robbins et al 1997).…”

Section: Long Term Complications Of Preeclampsiamentioning

confidence: 99%

Molecular Mechanisms of Preeclampsia

Cerdeira

2015

Cold Spring Harb Perspect Med

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156

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Preeclampsia is a pregnancy-specific disease characterized by new onset hypertension and proteinuria after 20 wk of gestation. It is a leading cause of maternal and fetal morbidity and mortality worldwide. Exciting discoveries in the last decade have contributed to a better understanding of the molecular basis of this disease. Epidemiological, experimental, and therapeutic studies from several laboratories have provided compelling evidence that an antiangiogenic state owing to alterations in circulating angiogenic factors leads to preeclampsia. In this review, we highlight the role of key circulating antiangiogenic factors as pathogenic biomarkers and in the development of novel therapies for preeclampsia.

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Preeclampsia and Retinopathy of Prematurity in Preterm Births

Abstract: Preeclampsia, but not gestational hypertension, was associated with a reduced risk of ROP in preterm births.

Cited by 53 publications

References 39 publications

Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

Retinopathy of prematurity in a cohort of neonates at Groote Schuur Hospital, Cape Town, South Africa

Molecular Mechanisms of Preeclampsia

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