Effects of Neonatal Hyperglycemia on Retinopathy of Prematurity and Visual Outcomes at 7 Years of Age: A Matched Cohort Study
| Autor: | Kelly Fredell, Heather Stewart, Coila Bevan, Joanna Black, Jane M Alsweiler, Jennifer A. Rogers, Kathryn Williamson, Myra Leung, Benjamin Thompson, Sabine Huth, Greg D. Gamble, Jane E. Harding, Tanya Poppe, Yannan Jiang, Christine Kevan, Geraint Phillips, Frank H. Bloomfield, Janene B. Biggs, Trecia A. Wouldes, Anna C Tottman |
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| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male Pediatrics medicine.medical_specialty Visual acuity genetic structures Visual Acuity Infant Premature Diseases 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics Diabetes mellitus medicine Humans Infant Very Low Birth Weight Retinopathy of Prematurity 030212 general & internal medicine Child business.industry Incidence (epidemiology) Infant Newborn Retinopathy of prematurity medicine.disease eye diseases Infant mortality Causality Cross-Sectional Studies Clinical research Hyperglycemia Pediatrics Perinatology and Child Health Female medicine.symptom business Neonatal Hyperglycemia Binocular vision Infant Premature |
| Zdroj: | The Journal of Pediatrics. 223:42-50.e2 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2020.04.059 |
| Popis: | To determine whether neonatal hyperglycemia is associated with retinopathy of prematurity (ROP), visual outcomes, and ocular growth at 7 years of age.Children born preterm (30 weeks of gestational age) at a tertiary hospital in Auckland, New Zealand, who developed neonatal hyperglycemia (2 blood glucose concentrations ≥153 mg/dL [8.5 mmol/L] 4 hours apart) were matched with children who were not hyperglycemic (matching criteria: sex, gestational age, birth weight, age, socioeconomic status, and multiple birth) and assessed at 7 years of corrected age. The primary outcome, favorable overall visual outcome (visual acuity ≤0.3 logarithm of the minimum angle of resolution, no strabismus, stereoacuity ≤240 arcsec, not requiring spectacles) was compared between groups using generalized matching criteria-adjusted linear regression models.Assessments were performed on 57 children with neonatal hyperglycemia (hyperglycemia group) and 54 matched children without hyperglycemia (control group). There were no differences in overall favorable visual outcome (OR 0.95, 95% CI 0.42-2.13, P = .90) or severe ROP incidence (OR 2.20, 95% CI 0.63-7.63, P = .21) between groups. Children with hyperglycemia had poorer binocular distance visual acuity (mean difference 0.08, 95% CI 0.03-0.14 logarithm of the minimum angle of resolution, P .01), more strabismus (OR 6.22, 95% CI 1.31-29.45, P = .02), and thicker crystalline lens (mean difference 0.14, 95% CI 0.04-0.24 mm, P .01). Maximum blood glucose concentration was greater in the ROP-treated group compared with the ROP-not treated and no ROP groups after adjusting for sex, gestational age, and birth weight z score (P = .02).Neonatal hyperglycemia was not associated with overall visual outcomes at 7 years of age. However, there were between-group differences for specific outcome measures relating to interocular lens growth and binocular vision. Further follow-up is required to determine implications on long-term visual outcome. |
| Databáze: | OpenAIRE |
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