Association between Severe Retinopathy of Prematurity and Postnatal Weight Gain in Very-Low-Birth-Weight Infants at Chiang Mai University Hospital

A. Wongnophirun; W. Tantiprabha; A. Wiwatwongwana; V. Khuwuthyakorn

doi:10.1055/s-0039-1693251

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(S 02): S139-S148
DOI: 10.1055/s-0039-1693251

Selected Abstracts

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association between Severe Retinopathy of Prematurity and Postnatal Weight Gain in Very-Low-Birth-Weight Infants at Chiang Mai University Hospital

Authors

A. Wongnophirun

¹Department of Paediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
W. Tantiprabha

²Division of Neonatology, Department of Paediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
A. Wiwatwongwana

³ROP Unit, Division of Paediatric Ophthalmology and Strabismus, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
V. Khuwuthyakorn

²Division of Neonatology, Department of Paediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Abstract

Full Text

Introduction: Poor postnatal weight gain was associated with low serum insulin-like growth factor-1 which is a key factor in pathogenesis of retinopathy of prematurity (ROP). Cutoff weight gains for predicting ROP and advanced stages of disease were demonstrated but varied between studies. Our aims were to investigate a potential association between postnatal weight gain and severe ROP requiring laser treatment and to identify an appropriate cutoff weight gain for predicting severe ROP requiring laser treatment in a Thai population.

Materials and Methods: Medical records of very-low-birth-weight (VLBW) infants who were admitted to the neonatal intensive care unit at Chiang Mai University Hospital during the period June 2014 to December 2016 and obtained ROP screenings were reviewed. Relative weight gain (RWG) and total caloric intake (TCI) on second, fourth, and sixth weeks of age were calculated and compared between groups of no ROP/mild ROP and severe ROP requiring laser treatment.

Results: This study included 139 VLBW infants, of which 24 (17.3%) had ROP requiring laser treatment. Infants with severe ROP requiring laser treatment had lower median birth weight (840 vs. 1,195 g, p < 0.001) and median gestational age (GA) (27 vs. 30 weeks, p < 0.001) than infants with no ROP/mild ROP. Apgar < 3 at 5 minutes (30.4 vs. 11.3%, p < 0.05), RDS requiring surfactant (58.3 vs. 29.6%, p < 0.01), patent ductus arteriosus (83.3 vs. 54.0%, p < 0.05), necrotizing enterocolitis (45.8 vs.14.8%, p < 0.01), intraventricular hemorrhage (66.7 vs. 44.3%, p < 0.05), bronchopulmonary dysplasia (95.8 vs. 49.6%, p < 0.001), hypotension (29.2 vs. 10.4%, p < 0.05), and packed red cell transfusion (87.5 vs. 46.1, p < 0.001) were significant risk factors of severe ROP requiring laser treatment. The infants with severe ROP requiring laser treatment had lower RWG at the second (p < 0.01) and fourth week of age (p < 0.05) and had lower TCI at the second week of age (p < 0.001) than those with no ROP/mild ROP. Multivariate logistic analysis demonstrated that GA <29.5 weeks (p < 0.01), hypotension (p < 0.05), RWG <2.9 g/kg/d (p < 0.05), and TCI <98.5 kcal/kg/d (p < 0.001) at the second week of age were independent risk factors of severe ROP requiring laser treatment.

Conclusion: In our series, poor weight gain and low caloric intake at the second week of age were significantly associated with severe ROP requiring laser treatment in VLBW infants. Monitoring weight gain and caloric intake during this period are essential and may improve outcome of ROP.

Keywords: postnatal weight gain; relative weight gain; retinopathy of prematurity; very low birth weight; caloric intake

Conflict of Interest: None declared.