Risk Factors in Retinopathy of Prematurity

Abstract

Objective: To analyze risk factors in retinopathy of prematurity (ROP). Patients and Methods: Four hundred forty-seven surviving very-low-birth-weight infants (birth weight ≤1,500 g) were enrolled in a retrospective study. Clinical data underwent multivariate analysis using stepwise logistic forward regression. Results: For 402 of the babies a complete dataset of 38 possible risk factors was available. Multivariate analysis showed 10 factors to be independently significant variables. Low birth weight, low gestational age, artificial ventilation for more than 7 days, high volume of blood transfusion and surfactant therapy were risk factors associated with higher rates of ROP. Necrotizing enterocolitis, maternal pre-eclampsia, lung maturation by antepartum betamethasone application, vitamin E and phototherapy were accompanied by a lower incidence of ROP. Conclusions: This study confirms several risk factors recognized by previous statistical analysis. In addition, this study reveals maternal pre-eclampsia, which is associated with chronic intrauterine stress, as a statistically independent factor and as having an influence on the incidence of ROP.

Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies

“…Low BW and GA have been implicated most directly in ROP development [23][24][25], but low WG as an independent risk factor for ROP development was just recently described. Hall et al [26], in 1995, related a low WG associated with severity of ROP in four survivors in a birth of quintuples with identical GA and similar BW.…”

Increased postnatal concentrations of pro-inflammatory cytokines are associated with reduced IGF-I levels and retinopathy of prematurity

“…We and others have identified low postnatal levels of IGF-I as a strong risk factor for ROP [1–3]. Other factors beyond low gestational age (GA) at birth and low postnatal levels of IGF-I that have been identified as risk factors for ROP include low birth weight and poor postnatal growth, sub-optimal oxygen therapy, depletion of the maternal supply of growth and nutritional factors, and red blood cell transfusion [1,4–6]. In addition to risk factors specifically associated with preterm birth, perinatal or neonatal infections followed by a systemic inflammatory response with the activation of pro-inflammatory cytokines have been suggested to increase the risk for severe ROP [7–10], but contradictory data have been reported [11–13].…”

Association of antenatal steroid and risk of retinopathy of prematurity: a systematic review and meta-analysis

“…It is a retino-proliferative disease in preterm infants consisting of initial hyperoxia-induced vascular obliteration, followed by hypoxia-induced aberrant vasoproliferation in an increasingly metabolically activated yet poorly vascularised retina 2 3. Low birth weight and low gestational age are the two main risk factors for ROP development 4. Other risk factors include prolonged oxygen therapy, artificial ventilation, blood transfusion and surfactant therapy 4–7.…”