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

Autor:	Garg, Parvesh M., Riddick, Robin A., Ansari, Md A.Y., Meilstrup, Asha C., Zepponi, David, Smith, Andrea, Mungan, Nils, Shenberger, Jeffrey, Hillegass, William B., Garg, Padma P.
Předmět:	RISK assessment INTESTINAL perforation STATISTICAL significance RESEARCH funding FISHER exact test MULTIPLE regression analysis POSTNATAL care RETROSPECTIVE studies SEVERITY of illness index ACUTE kidney failure CEPHALOMETRY MANN Whitney U Test CHI-squared test MULTIVARIATE analysis DESCRIPTIVE statistics NEONATAL necrotizing enterocolitis LONGITUDINAL method ODDS ratio MEDICAL records ACQUISITION of data GESTATIONAL age FETAL diseases STATISTICS BIRTH weight CONFIDENCE intervals DATA analysis software RETROLENTAL fibroplasia DISEASE risk factors DISEASE complications CHILDREN
Zdroj:	American Journal of Perinatology; Nov2024, Vol. 41 Issue 15, p2152-2164, 13p
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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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