Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation.

Autor: Garg PM; Department of Pediatrics/Neonatology, Atrium Health Wake Forest Baptist, Wake Forest School of Medicine, Winston Salem, North Carolina.; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi., Riddick RA; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi., Ansari MAY; Department of Data Sciences, University of Mississippi Medical Center, Jackson, Mississippi., Meilstrup AC; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi., Zepponi D; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi., Smith A; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi., Mungan N; Department of Ophthalmology, University of Mississippi Medical Center, Jackson, Mississippi., Shenberger J; Department of Pediatrics/Neonatology, Connecticut Children's, Hartford, Connecticut., Hillegass WB; Department of Data Sciences, University of Mississippi Medical Center, Jackson, Mississippi.; Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi., Garg PP; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
Jazyk: angličtina
Zdroj: American journal of perinatology [Am J Perinatol] 2024 Nov; Vol. 41 (15), pp. 2152-2164. Date of Electronic Publication: 2024 Apr 02.
DOI: 10.1055/a-2297-8644
Abstrakt: Objective:  This study aimed to identify the clinical and growth parameters associated with retinopathy of prematurity (ROP) in infants with necrotizing enterocolitis (NEC) and spontaneous ileal perforation (SIP).
Study Design:  We conducted a retrospective cohort study that compared clinical data before and after NEC/SIP onset in neonates, categorizing by any ROP and severe ROP (type 1/2) status.
Results:  The analysis included 109 infants with surgical NEC/SIP. Sixty infants (60/109, 55%) were diagnosed with any ROP, 32/109 (29.3%) infants (22% type 1 and 7.3% type 2) with severe ROP. On univariate analysis, those with severe ROP (32/109, 39.5%) were of lower median gestational age (GA, 23.8 weeks [23.4, 24.6] vs. 27.3 [26.3, 29.0], p  < 0.001), lower median birth weight (625 g [512, 710] vs. 935 [700, 1,180], p  < 0.001) and experienced higher exposure to clinical chorioamnionitis (22.6 vs. 2.13%, p  < 0.006), and later median onset of ROP diagnosis (63.0 days [47.0, 77.2] vs. 29.0 [19.0, 41.0], p  < 0.001), received Penrose drain placement more commonly (19 [59.4%] vs. 16 [34.0%], p  = 0.04), retained less residual small bowel (70.0 cm [63.1, 90.8] vs. 90.8 [72.0, 101], p  = 0.007) following surgery, were exposed to higher FiO 2 7 days after birth ( p  = 0.001), received ventilation longer and exposed to higher FiO 2 at 2 weeks ( p  < 0.05) following NEC and developed acute kidney injury (AKI) more often (25 [86.2%] vs. 20 [46.5%], p  = 0.002) than those without ROP. Those with severe ROP had lower length, weight for length, and head circumference z scores. In an adjusted Firth's logistic regression, GA (adjusted odds ratio [aOR] = 0.51, 95% confidence interval [CI]: [0.35, 0.76]) and diagnosis at later age (aOR = 1.08, 95% CI: [1.03, 1.13]) was shown to be significantly associated with any ROP.
Conclusion:  Infants who develop severe ROP following surgical NEC/SIP are likely to be younger, smaller, have been exposed to more O 2 , develop AKI, and grow poorly compared with those did not develop severe ROP.
Key Points: · Thirty percent of infants with NEC/SIP had severe ROP.. · Those with severe ROP had poor growth parameters before and after NEC/SIP.. · Risk factors based ROP prevention strategies are needed to have improved ophthalmic outcomes..
Competing Interests: None declared.
(Thieme. All rights reserved.)
Databáze: MEDLINE
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