Risk of developing retinopathy of prematurity in infants varying in hematological parameters, gestational age and some treatment-related factors
DOI:
https://doi.org/10.31288/oftalmolzh201842631Keywords:
retinopathy of prematurity, risk factors, thrombocytopenia, odds ratio, confidence intervalAbstract
Background: Investigating risk factors for severe retinopathy of prematurity (ROP) is important, given the prevalence of ROP.
Purpose: To determine the association of severe ROP with hematological parameters, gestational age and some treatment-related factors.
Materials and Methods: The investigation involved a retrospective analysis of some hematological parameters (red blood cell (RBC), white blood cell (WBC) and platelet counts (PLC)) in 1248 preterm neonates. Hematological results were (a) abstracted from neonates’ medical records kept while infants were staying in neonatal care units, and (b) compared with Children’s Reference Ranges for Routine Hematology Tests at age 1 month. Statistical analyses were performed using Medstat Software version 16.8.4. Models were developed and analyzed using EZR version 1.32.
Results: We found the following independent variables to be associated with an increased risk of severe ROP: low gestational age (OR, 0.52; 95% CI, 0.45 – 0.60; p < 0.001), mechanical ventilation (OR, 2.9; 95% CI, 1.4 – 5.9; p = 0.003), blood transfusion (OR, 1.23; 95% CI, 1.03 – 1.49; p = 0.02), and thrombocytopenia (OR, 0.72; 95% CI, 0.60 – 0.87; p < 0.001).
Conclusion: Values of these independent variables should be taken into account when performing longitudinal screening for ROP.
References
Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008 Feb;84(2):77-82. https://doi.org/10.1016/j.earlhumdev.2007.11.009
Dorfman A, Dembinska O, Chemtob S, Lachapelle P. Early manifestations of postnatal hyperoxia on the retinal structure and function of the neonatal rat. Invest Ophthalmol Vis Sci. 49(1):458-66 https://doi.org/10.1167/iovs.07-0916
Katargina LA, Kogoleva LV. [Pathogenesis of vision abnormalities in infants with retinopathy of prematurity]. In: Avetisov SE, Kaschenko TP, Shamshinova AM, editors. [Visual function and correction of its abnormalities in children: Guide for physicians]. Moscow: Meditsina; 2005. pp. 459-75. Russian
Katargina LA, Osipova NA. [Basic principles of animal modeling of retinopathy of prematurity]. Rossiyskaya pediatricheskaya oftal'mologiya. 2014; 1: 54-60. Russian
Fruttiger M. Development of the mouse retinal vasculature: angiogenesis versus vasculogenesis. Invest Ophthalmol Vis Sci. 2002 Feb;43(2):522-7.
Jensen AK, Ying GS, Huang J, Karp K, Quinn GE, Binenbaum G. Thrombocytopenia and retinopathy of prematurity. J AAPOS. 2011 Feb 1;15(1):e3-e4. https://doi.org/10.1016/j.jaapos.2011.01.015
Smith LE. Pathogenesis of retinopathy of prematurity. Growth Horm IGF Res. 2004;14:S140-4. https://doi.org/10.1016/j.ghir.2004.03.030
Italiano JE, Richardson JL, Patel-Hett S, et al. Angiogenesis is regulated by a novel mechanism: pro- and antiangiogenic proteins are organized into separate platelet alpha granules and differentially released. Blood. 2008 Feb 1;111(3):1227-33. https://doi.org/10.1182/blood-2007-09-113837
Children's Reference Ranges for Routine Haematology Tests. https://www.nbt.nhs.uk/sites/default/files/Childrens%20FBC%20Reference%2.
Lyakh YuE, Guryanov VG, Khomenko VN, Panchenko OA. [Basics of Computer Biostatistics. Data Analysis in biology, medicine and pharmacy statistical using statistical software Med Stat]. Donetsk: Papakitsa EK; 2006. Russian
Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013; 48: 452-8. https://doi.org/10.1038/bmt.2012.244
Fedotova SP, Adakhovska AA, Zaichko ES, Katsan SV. [Risk factors for developing retinopathy of prematurity in preterm infants]. Oftalmologicheskii zhurnal Kazakhstana. 2017;1-2(51):69-76. Russian
Stewart MW. The expanding role of vascular endothelial growth factor inhibitors in ophthalmology. Mayo Clin Proc. 2012 Jan;87(1):77-88 https://doi.org/10.1016/j.mayocp.2011.10.001
Klimkin AS, Medvedeva MV. [Current views on retinopathy of prematurity]. Vestnik RAMN. 2014;3-4:36-42. Russian. https://doi.org/10.15690/vramn.v69.i3-4.993
Lundgren P, Lundberg L, Hellgren G, et al. Aggressive posterior retinopathy of prematurity is associated with multiple infectious episodes and thrombocytopenia. Neonatology. 2017;111(1):79-85. https://doi.org/10.1159/000448161
Vinekar A, Hegde K, Gilbert C, et al. Do platelets have a role in the pathogenesis of aggressive posterior retinopathy of prematurity? Retina. 2010;30:S20-23. https://doi.org/10.1097/IAE.0b013e3181cafc30
McColm JR, Hartnett ME. Retinopathy of prematurity: current understanding based on clinical trials and animal models. In: Hartnett ME, Trese M, Capone A Jr, Keats BJB, Steidl SM, editors. Pediatric Retina. 1st ed. Philadelphia: Lippincott Williams & Wilkins;
Pau H. Retinopathy of prematurity: Clinic and Pathogenesis. Ophthalmologica. 2008;222(4):220-4.2005. pp. 387-409. https://doi.org/10.1159/000130069
Woo SJ, Park KH, Ahn J. A co-twin study of the relative effect of birth weight and gestational age on retinopathy of prematurity. Eye (Lond). 2011 Nov;25(11):1478-83. https://doi.org/10.1038/eye.2011.208
EXPRESS Group. Incidence of and risk factors for neonatal morbidity after active perinatal care: Extremely Preterm Infants Study in Sweden (EXPRESS). Acta Paediatr. 2010;99(7):978-92. https://doi.org/10.1111/j.1651-2227.2010.01846.x
Katsan SV, Boichuk IM, Zaichko ES. [Prevalence and risk of the need for treatment of retinopathy in premature infants varying in birth weight and gestational age]. Oftalmologiia. Vostochnaia Evropa. 2017;7(4):513-23. Russian
García-Serrano JL, Ramírez-García MC, Piñar-Molina R. [Retinopathy of prematurity in multiple births: risk analysis for plus disease]. Arch Soc Esp Oftalmol. 2009 Apr;84(4):191-8. https://doi.org/10.4321/S0365-66912009000400005
Niwald A. [Risk factors of 3rd stage retinopathy of prematurity progression]. Klin Oczna. 2000;102(6):449-53.
Pinheiro AM, Silva WA, Bessa CG, Cunha HM, Ferreira MA, Gomes AH. [Incidence and risk factors of retinopathy of prematurity in University Hospital Onofre Lopes, Natal (RN)-Brazil]. Arq Bras Oftalmol. 2009 Jul-Aug;72(4):451-6. https://doi.org/10.1590/S0004-27492009000400005
Hakeem AH, Mohamed GB, Othman MF. Retinopathy of prematurity: a study of prevalence and risk factors. Middle East Afr J Ophthalmol. 2012 Jul-Sep;19(3):289-94. https://doi.org/10.4103/0974-9233.97927
Thomas K, Shah PS, Canning R, et al. Retinopathy of prematurity: Risk factors and variability in Canadian neonatal intensive care units. J Neonatal Perinatal Med. 2015 Oct 24;8(3):207-14. https://doi.org/10.3233/NPM-15814128
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