TY - JOUR
T1 - Late postnatal systemic steroids predispose to retinopathy of prematurity in very-low-birth-weight infants
T2 - A comparative study
AU - Smolkin, Tatiana
AU - Steinberg, Maya
AU - Sujov, Polo
AU - Mezer, Eedy
AU - Tamir, Ada
AU - Makhoul, Imad R.
PY - 2008/4
Y1 - 2008/4
N2 - Background and objective: Retinopathy of prematurity (ROP) develops mostly in very-low-birth-weight (VLBW) premature infants. Besides prematurity and hyperoxia, other variables have been brought up as risk factors for ROP. We aimed to search risk factors for ROP by comparing two groups of preemies, one with and the other without ROP. Patients and methods: During 2004-2006, 27 VLBW premature infants developed ROP (ROP group). For each neonate in the ROP group, we chose a neonate born at similar gestational age (GA) (±1week) but without ROP (control group). For each neonate of both groups, we recorded demographic, maternal, gestational, intrapartum, neonatal, interventional, growth and ophthalmologic data from patients' medical records. Results: Eleven of the tested variables were significantly different between the ROP and control groups in univariate analysis. However, only seven of these variables remained significantly different between groups when controlling each variable for GA: bronchopulmonary dysplasia (BPD, p = 0.04), duration of hospitalization (p = 0.017), high-frequency oscillatory ventilation (HFOV, p = 0.033), duration of oxygen therapy (p = 0.023), surfactant therapy (p = 0.045), inhaled steroids (p = 0.015) and systemic steroids for BPD (p = 0.007). These seven significant variables were related to respiratory morbidity and interventions. Multiple stepwise logistic regression including all significant variables in the univariate analysis showed that only systemic steroids remained significantly different between groups (p = 0.007, OR 5.42, 95% CI 1.60-18.34). Conclusion: Significantly more neonates in the ROP group received late postnatal systemic steroids as compared to controls. We speculate that steroids, by altering insulin growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) expression, might contribute to the pathogenesis of ROP.
AB - Background and objective: Retinopathy of prematurity (ROP) develops mostly in very-low-birth-weight (VLBW) premature infants. Besides prematurity and hyperoxia, other variables have been brought up as risk factors for ROP. We aimed to search risk factors for ROP by comparing two groups of preemies, one with and the other without ROP. Patients and methods: During 2004-2006, 27 VLBW premature infants developed ROP (ROP group). For each neonate in the ROP group, we chose a neonate born at similar gestational age (GA) (±1week) but without ROP (control group). For each neonate of both groups, we recorded demographic, maternal, gestational, intrapartum, neonatal, interventional, growth and ophthalmologic data from patients' medical records. Results: Eleven of the tested variables were significantly different between the ROP and control groups in univariate analysis. However, only seven of these variables remained significantly different between groups when controlling each variable for GA: bronchopulmonary dysplasia (BPD, p = 0.04), duration of hospitalization (p = 0.017), high-frequency oscillatory ventilation (HFOV, p = 0.033), duration of oxygen therapy (p = 0.023), surfactant therapy (p = 0.045), inhaled steroids (p = 0.015) and systemic steroids for BPD (p = 0.007). These seven significant variables were related to respiratory morbidity and interventions. Multiple stepwise logistic regression including all significant variables in the univariate analysis showed that only systemic steroids remained significantly different between groups (p = 0.007, OR 5.42, 95% CI 1.60-18.34). Conclusion: Significantly more neonates in the ROP group received late postnatal systemic steroids as compared to controls. We speculate that steroids, by altering insulin growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) expression, might contribute to the pathogenesis of ROP.
KW - Bronchopulmonary dysplasia
KW - High-frequency ventilation
KW - Prematurity
KW - Retinopathy of prematurity
KW - Steroids
UR - http://www.scopus.com/inward/record.url?scp=41949087372&partnerID=8YFLogxK
U2 - 10.1111/j.1651-2227.2008.00629.x
DO - 10.1111/j.1651-2227.2008.00629.x
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C2 - 18298780
AN - SCOPUS:41949087372
SN - 0803-5253
VL - 97
SP - 322
EP - 326
JO - Acta Paediatrica, International Journal of Paediatrics
JF - Acta Paediatrica, International Journal of Paediatrics
IS - 3
ER -