Postnatal kilo alımı ve diğer risk faktörlerin şiddetli prematüre retinopatisi üzerindeki etkisi

Year 2024, , 345 - 352, 23.09.2024

Furkan Kırık , Şenay Aşık Nacaroğlu , Özgül Salihoğlu , Merve Sena Kunduracı , İsmail Onur , Ulviye Yiğit

https://doi.org/10.21673/anadoluklin.1492395

Abstract

Amaç: Postnatal kilo alımı özelliklerinin ve çoklu risk faktörlerinin tedavi gerektiren prematüre retinopatisi üzerindeki etkisinin değerlendirilmesi.

Yöntemler: Üçüncü basamak bir sevk merkezinde prematüre retinopatisi nedeniyle takip edilen preterm infantların tıbbi kayıtları retrospektif olarak incelendi. İnfantlar Tedavi (-) (tedavisiz retinal matürasyon) ve tedavi (+) (tedavi gerekli) olarak gruplandırıldı. Prematüre retinopatisi bulguları, 4. ve 6. haftalardaki kilo alımı, kilo alımı oranları ve klinik özellikler not edildi. Kilo alımı ve kilo alımı oranı için en iyi kesim noktaları alıcı işletim karakteristik eğrisi altı alan ile değerlendirildi. Risk faktörleri lojistik regresyon modeli ile belirlendi.

Bulgular: İki yüz bir preterm infanttan 28’i (%13,5) tedavi (+) grubundaydı. Tedavi (+) grubunda doğum ağırlığı, gebelik yaşı, kilo alımı ile 4. ve 6. haftalardaki kilo alımı oranı daha düşük, oksijen tedavisi ve hastanede yatış süresi daha uzun ve bronkopulmoner displazi, nekrotizan enterokolit, uzamış mekanik ventilasyon ve eritrosit transfüzyonu öyküsü daha yaygındı (p<0,05). En iyi kesim noktaları (ve alıcı işletim karakteristik eğrisi altı alan) 4. ve 6. haftalardaki kilo alımı için sırasıyla 297,5 g (0,779) ve 504,5 g (0,771) ve kilo alımı oranları için %21,02 (0,697) ve %54,80 (0,670) olarak hesaplandı. Bronkopulmoner displazi öyküsü ve uzamış mekanik ventilasyon bağımsız olarak tedavi gerektiren prematüre retinopatisi ile ilişkiliydi.

Sonuç: Dördüncü haftada düşük kilo alımı profili, bronkopulmoner displazi ve uzamış mekanik ventilasyon öyküsü olan preterm infantlar tedavi gerektiren prematüre retinopatisi gelişimi açısından dikkatle izlenmelidir.

Keywords

Ağırlık artışı, bronkopulmoner displazi, doğum ağırlığı, mekanik ventilasyon, prematüre retinopatisi

The effect of postnatal weight gain and other risk factors on severe retinopathy of prematurity

Abstract

Aim: To assess the effect of postnatal weight gain characteristics and multiple risk factors on treatment-required retinopathy of prematurity.

Methods: The medical records of preterm infants who were followed up for retinopathy of prematurity in a tertiary referral center were retrospectively reviewed. Infants were grouped as Treatment(-) (retinal maturation without treatment) and Treatment(+) (treatment required). Retinopathy of prematurity findings, weight gain and weight gain rates at the 4th and 6th weeks, and clinical features were noted. The best cut-off points for the weight gain and weight gain rate were assessed with the area under the receiver operating characteristic curve. Risk factors were determined by the logistic regression model.

Results: Twenty-eight of 201 preterm infants (13.5%) were in the treatment (+) group. Birth weight, gestational age, weight gain, and weight gain rate at the 4th and 6th weeks were lower, the duration of oxygen therapy and hospitalization was longer, and a history of bronchopulmonary dysplasia, necrotizing enterocolitis, prolonged mechanical ventilation, and erythrocyte transfusion was more common in the treatment (+) group (p<0.05). The best cut-off points (and area under the receiver operating characteristic curve) were calculated as 297.5 g (0.779) and 504.5 g (0.771) for weight gain and 21.02% (0.697) and 54.80% (0.670) for weight gain rates at the 4th and 6th weeks, respectively. History of bronchopulmonary dysplasia and prolonged mechanical ventilation were independently associated with severe retinopathy of prematurity.

Conclusion: Preterm infants with a history of low weight gain profile at the 4th week, bronchopulmonary dysplasia, and prolonged mechanical ventilation should be carefully monitored for the development of the treatment-required retinopathy of prematurity.

Keywords

Birth weight, bronchopulmonary dysplasia, mechanical ventilation, retinopathy of prematurity, weight gain

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