Document Detail

Mode of delivery and threshold retinopathy of prematurity in pre-term ELBW neonates.
MedLine Citation:
PMID:  17429909     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Retinopathy of prematurity (ROP) is a multifactorial disease, but little is known about its relationship with perinatal risk factors. We tested the hypothesis that the mode of delivery may be associated with threshold ROP as defined by CRYO-ROP. METHODS: We conducted a prospective, cohort analysis of a database of all extremely low birth weight (ELBW) neonates (= birth weight < 1000 g) admitted over a 8-year period from 1997 to 2004 to a large tertiary neonatal intensive care unit in a urban area of northern Italy and screened for ROP. Incidence of threshold ROP was calculated for the whole studied population. The definition of threshold ROP was as defined by the CRYO-ROP study. Univariate analysis was performed to look for significant associations between threshold ROP and several possible associated factors, and among them, the mode of delivery (vaginal delivery or caesarean section). When an association was indicated by p < 0.05, multiple logistic regression was used to determine the factors significantly associated with ROP. RESULTS: Enrolled ELBW neonates were 174, and 46 of them (26.4%) displayed threshold ROP. Threshold ROP occurred in 40.9% (27 of 66) of the neonates vaginally delivered and in 17.5% (19 of 108) of those born via caesarean section (R.R. 3.35; 95% CI 1.230-4.855; p = 0.008 at univariate analysis, and = 0.04 at multivariate logistic regression after controlling for birth weight, gestational age, intraventricular haemorrhage grade 2 or more, days on supplemental oxygen, systemic fungal infection). Birth by vaginal delivery was not significantly associated with other major sequelae of prematurity (intraventricular haemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis). CONCLUSIONS: In our Institution birth by vaginal delivery is a significant and independent predictor of threshold ROP in ELBW infants. We suggest to consider closely ophthalmological surveillance for pre-term ELBW infants born this mode.
P Manzoni; D Farina; A Maestri; C Giovannozzi; M L Leonessa; R Arisio; G Gomirato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  96     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-04-12     Completed Date:  2007-05-15     Revised Date:  2008-01-25    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  221-6     Citation Subset:  IM    
Neonatology and Hospital NICU, Azienda Ospedaliera OIRM-SantAnna Hospital, Turin, Italy.
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MeSH Terms
Cohort Studies
Databases, Factual
Delivery, Obstetric / adverse effects*
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal
Retinopathy of Prematurity / etiology*
Risk Factors
Comment In:
Acta Paediatr. 2007 Oct;96(10):1552   [PMID:  17714545 ]

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

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