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Maternal and neonatal factors associated with poor early weight gain and later retinopathy of prematurity

Authors

  • Margareta Hök Wikstrand,

    1. Department of Ophthalmology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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  • Anna-Lena Hård,

    1. Department of Ophthalmology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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  • Aimon Niklasson,

    1. Department of Pediatrics, Institute of Clinical Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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  • Lois Smith,

    1. Department of Ophthalmology, Children’s Hospital, Harvard Medical School, Boston, MA, USA
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  • Chatarina Löfqvist,

    1. Department of Ophthalmology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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  • Ann Hellström

    1. Department of Ophthalmology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Ann Hellström, M.D., Ph.D., Section of Pediatric Ophthalmology, Queen Silvia Children’s Hospital, The Sahlgrenska Academy, University of Gothenburg, Smörslottsgatan 1, S-416 85 Gothenburg, Sweden.
Tel: + 46 31 343 10 00 |
Fax: + 46 31 848952 |
Email: ann.hellstrom@medfak.gu.se

Abstract

Aim:  To identify factors associated with poor early weight gain as reflected in an alarm system, WINROP, and risk of later proliferative retinopathy of prematurity (ROP) in infants with gestational age (GA) < 28 weeks.

Methods:  Infants with a WINROP alarm and proliferative ROP, the ‘alarm group’ (n = 23), were matched to GA and gender to a ‘no alarm group’ (n = 23) with no WINROP alarm and no or mild ROP. Retrospectively maternal variables, birth characteristics and neonatal factors, during the first three postnatal weeks, were compared.

Results:  The ‘alarm group’ had lower birth weight (BW) and BW standard deviation score, longer stay in ventilator, more insulin and corticosteroid treatments, and lower white blood cell count. In a logistic regression model, BW standard deviation score, insulin, low white blood cell count, absence of both elevated C-reactive protein and premature rupture of membranes were associated with proliferative ROP and WINROP alarm (p = 0.000, r2 = 0.704).

Conclusions:  This study shows that prenatal factors resulting in low BW have persisting effects on early postnatal growth, metabolism and inflammatory response. Future prospective studies will focus on the link between these factors and pathological retinal vessel development in the early postnatal period to find possible preventive strategies.

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