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

Year 2024, Volume: 29 Issue: 3, 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

References

• Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet. 2013;382(9902):1445-57.
• Sabri K, Ells AL, Lee EY, Dutta S, Vinekar A. Retinopathy of Prematurity: A Global Perspective and Recent Developments. Pediatrics. 2022;150(3):e2021053924.
• Hardy RJ, Palmer EA, Dobson V, et al. Risk analysis of prethreshold retinopathy of prematurity. Arch Ophthalmol. 2003;121(12):1697-701.
• Bas AY, Demirel N, Koc E, et al. Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units. Br J Ophthalmol. 2018;102(12):1711-6.
• Darlow BA, Hutchinson JL, Henderson-Smart DJ, et al. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics. 2005;115(4):990-6.
• Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018;63(5):618-37.
• Hellström A, Ley D, Hansen-Pupp I, et al. New insights into the development of retinopathy of prematurity--importance of early weight gain. Acta Paediatr. 2010;99(4):502-8.
• Löfqvist C, Andersson E, Sigurdsson J, et al. Longitudinal postnatal weight and insulin-like growth factor I measurements in the prediction of retinopathy of prematurity. Arch Ophthalmol. 2006;124(12):1711-8.
• Wu C, Löfqvist C, Smith LE, VanderVeen DK, Hellström A; WINROP Consortium. Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity. Arch Ophthalmol. 2012;130(8):992-9.
• Anuk İnce D, Gülcan H, Hanta D, et al. Poor postnatal weight gain predicts stage 3+ retinopathy of prematurity in very low birth weight infants. Turk J Pediatr. 2013;55(3):304-8.
• Chaves-Samaniego MJ, Gómez Cabrera C, Chaves-Samaniego MC, et al. Multicenter validation study of the WINROP algorithm as a method for detecting retinopathy of prematurity. J Matern Fetal Neonatal Med. 2020;33(8):1302-6.
• Thomas D, Madathil S, Thukral A, et al. Diagnostic Accuracy of WINROP, CHOP-ROP and ROPScore in Detecting Type 1 Retinopathy of Prematurity. Indian Pediatr. 2021;58(10):915-21.
• Hellström A, Engström E, Hård AL, et al. Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics. 2003;112(5):1016-20.
• Fu Y, Lei C, Qibo R, et al. Insulin-like growth factor-1 and retinopathy of prematurity: A systemic review and meta-analysis. Surv Ophthalmol. 2023;68(6):1153-65.
• Sethi NK, Jain B, Gupta NR, Singh SP, Sethi G, Chadha C. Study to evaluate the relation between weight gain in infants and occurrence of retinopathy of prematurity. Indian J Ophthalmol. 2023;71(3):890-4.
• VanderVeen DK, Martin CR, Mehendale R, et al. Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity. PLoS One. 2013;8(5):e64325.
• Athikarisamy S, Desai S, Patole S, Rao S, Simmer K, Lam GC. The Use of Postnatal Weight Gain Algorithms to Predict Severe or Type 1 Retinopathy of Prematurity: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(11):e2135879.
• Akın MŞ, Yiğit Ş. The effects of early nutritional contents in premature infants on the development and severity of retinopathy. Trends in Pediatrics. 2023;4:238-6.
• Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics. 2018;142(6):e20183061.
• International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123(7):991-9.
• Kavurt S, Yücel H, Hekimoğlu H, Baş AY, Demirel N, Türkbay D. Prematüre retinopatisi gelişen olgularda risk faktörlerinin değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi. 2012;55(3):125-31.
• Bas AY, Koc E, Dilmen U; ROP Neonatal Study Group. Incidence and severity of retinopathy of prematurity in Turkey. Br J Ophthalmol. 2015;99(10):1311-4.
• Palmer EA, Flynn JT, Hardy RJ, et al. Incidence and Early Course of Retinopathy of Prematurity. Ophthalmology. 2020;127(4S):S84-96.
• Wallace DK, Kylstra JA, Phillips SJ, Hall JG. Poor postnatal weight gain: a risk factor for severe retinopathy of prematurity. J AAPOS. 2000;4(6):343-7.
• Engström E, Niklasson A, Wikland KA, Ewald U, Hellström A. The role of maternal factors, postnatal nutrition, weight gain, and gender in regulation of serum IGF-I among preterm infants. Pediatr Res. 2005;57(4):605-10.
• Çetinkaya M, Köksal N, Özkan H, Özmen AT. Prematüre Retinopatisi ile Serum İnsülin Benzeri Büyüme Faktörü-1 Düzeyleri Arasındaki İlişki. Güncel Pediatri. 2008;6(4):47-52.
• Binenbaum G, Ying GS, Quinn GE, et al. The CHOP postnatal weight gain, birth weight, and gestational age retinopathy of prematurity risk model. Arch Ophthalmol. 2012;130(12):1560-5.
• Binenbaum G. Algorithms for the prediction of retinopathy of prematurity based on postnatal weight gain. Clin Perinatol. 2013;40(2):261-70.
• Sun CS. Relation of target SpO2 levels and clinical outcome in ELBW infants on supplemental oxygen. Pediatr Res. 2002;51:305A.
• Fares A, Abdelmonaim S, Sayed D, et al. Validation of WINROP algorithm as screening tool of retinopathy of prematurity among Egyptian preterm neonates. Eye (Lond). 2024;38(8):1562-6.
• Desai S, Athikarisamy SE, Lundgren P, Simmer K, Lam GC. Validation of WINROP (online prediction model) to identify severe retinopathy of prematurity (ROP) in an Australian preterm population: a retrospective study. Eye (Lond). 2021;35(5):1334-9.
• Bai YC, Wu R, Chen SZ, et al. Efficacy of the WINROP algorithm for retinopathy of prematurity screening in Southern China. Int J Ophthalmol. 2021;14(1):127-32.
• Ekinci DY, Bayraktar H, Sero OL, Okur N. Retrospective validation of the postnatal growth and retinopathy of prematurity (G-ROP) and Colorado retinopathy of prematurity (CO-ROP) models in a Turkish cohort. Turk J Pediatr. 2023;65(3):398-405.
• Fortes Filho JB, Bonomo PP, Maia M, Procianoy RS. 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. Graefes Arch Clin Exp Ophthalmol. 2009;247(6):831-6.
• Zhu T, Zhang L, Zhao F, Qu Y, Mu D. Association of maternal hypertensive disorders with retinopathy of prematurity: A systematic review and meta-analysis. PLoS One. 2017;12(4):e0175374.
• Bental Y, Reichman B, Shiff Y, et al. Impact of maternal diabetes mellitus on mortality and morbidity of preterm infants (24-33 weeks’ gestation). Pediatrics. 2011;128(4):e848-55.
• Tunay ZÖ, Özdemir Ö, Acar DE, Öztuna D, Uraş N. Maternal Diabetes as an Independent Risk Factor for Retinopathy of Prematurity in Infants With Birth Weight of 1500 g or More. Am J Ophthalmol. 2016;168:201-6.