Race, <i>Candida</i> Sepsis, and Retinopathy of Prematurity

Abstract

The objective of this observational cohort study at Georgetown University Hospital from January 1, 1994 through December 31, 1997 was to investigate race, Candida sepsis, and duration of oxygen exposure in infants with retinopathy of prematurity (ROP) with birth weight ≤1,000 g. The incidence of ROP was 70.8% (114/161). The incidence of stage III or greater ROP in the Caucasian infants was significantly higher at 46.7% (14/30) than in the African-American infants at 23.8% (20/84) with p < 0.02. In addition, the incidence of threshold disease was higher in Caucasian infants 33.3% (10/30) when compared to African-American infants 9.5% (8/84) with p < 0.002. Using multiple logistic regression, African-American race was found to be an independent protective factor against developing severe ROP [adjusted odds ratio 0.39; 95% confidence interval (UCI) 0.16–0.97]. Extremely-low-birth-weight African-American infants with comparable severity of illness (including birth weight, gestational age, duration of supplemental oxygen exposure, and Candida sepsis) are less likely to develop severe ROP than Caucasian infants.

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

“…Finally, seven studies plus an abstract, all retrospective cohort studies, were found by both the authors and were included for analysis in this review. [12][13][14][15][16][17][18]20 The characteristics of these studies are presented in Table 1. There were many similarities and differences in the studies.…”

“…12,16 Data were analyzed with Review Manager 4.2 software (Nordic Cochrane Center, Cochrane Collaboration, K behavn, Denmark). A fixed effects meta-analysis model was used in this review because the combination of treatment effect estimates across studies incorporates an assumption that the studies are each estimating exactly the same quantity.…”

“…The cases and control groups in each of the studies were closely matched and the internal validity of the data was present in half of the studies and was either absent 12 or not available in others. 16,17,20 Raw data of two studies 12,16 from the same institution were combined to avoid duplication as their study periods overlapped and had a total of 185 patients including 133 patients from the study by Mittal et al 12 …”

“…[5][6][7] Neonatal candidemia occurs in 1.6 to 9% of VLBW infants 1,2 and 4 to 15% in extremely low birth weight infants (ELBW; birth weight <1000 g), with the 30-day mortality approaching 40%. 1,4,[8][9][10][11] The occurrence of candidemia has been reported as an independent risk factor associated with development of retinopathy of prematurity (ROP) [12][13][14][15][16][17] and ROP requiring laser surgery. 12 Yet others 18 have found such an association only in a univariate analysis but not in a multiple logistic regression model.…”

Cumulative illness severity and progression from moderate to severe retinopathy of prematurity

“…21,34,35 Lower rates of severe ROP in black infants may be due to milder illness severity in black infants compared to nonblack infants of otherwise apparently equal risk for severe eye disease. 36, 37 The results of the current study do not confirm this speculation.…”