Document Detail


Early weight gain predicts retinopathy in preterm infants: new, simple, efficient approach to screening.
MedLine Citation:
PMID:  19289449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The risk for sight-threatening retinopathy of prematurity is predicted by using gestational age and/or weight at birth. All infants below a threshold undergo serial ophthalmologic examinations for identification of those who would benefit from treatment (approximately 10%). We hypothesized that factoring in postnatal weight gain could identify children at risk for sight-threatening retinopathy of prematurity more specifically and earlier. METHODS: Weekly weights from birth to postmenstrual week 36 were retrospectively entered into a surveillance system that gave an alarm when the rate of weight gain decreased to a certain level. For all children (N = 354) screened and/or treated for retinopathy of prematurity at Sahlgrenska University Hospital in 2004-2007, weekly weights were recorded. One child was excluded because of known nonphysiologic weight gain (hydrocephalus). RESULTS: For 127 (36%) of 353 children, no alarm was given; for 40%, alarm at low risk was given after postmenstrual week 32. None of those children developed retinopathy of prematurity requiring treatment. Of the remaining 24% of children who received alarm at high or low risk before 32 postmenstrual weeks, 41% developed proliferative retinopathy of prematurity and 29% were treated because of sight-threatening disease. The median time from alarm to treatment was 9 weeks. CONCLUSIONS: The weight, insulin-like growth factor, neonatal retinopathy of prematurity algorithm detected early 100% of infants who developed retinopathy of prematurity requiring treatment and correctly predicted the majority who did not require treatment. With this simple postnatal evaluation, costly stressful eye examinations can be markedly reduced (approximately 75% of infants). In addition, early identification of children at risk may lead to the initiation of interventions and possibly prevent sight-threatening retinopathy of prematurity.
Authors:
Ann Hellström; Anna-Lena Hård; Eva Engström; Aimon Niklasson; Eva Andersson; Lois Smith; Chatarina Löfqvist
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-16
Journal Detail:
Title:  Pediatrics     Volume:  123     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-01     Completed Date:  2009-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e638-45     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Ophthalmology, The Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. ann.hellstrom@medfak.gu.se
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Mass Screening
Patient Selection
Retinopathy of Prematurity / epidemiology*,  therapy
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Weight Gain / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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