Objective: Strategies to reduce Retinopathy of Prematurity (ROP) have focused primarily on respiratory management. Hyperglycemia (HG) and insulin use, risk factors for adult diabetic retinopathy, as well as growth rates may be modifiable variables useful to reduce ROP. ) done in the first 29 days of life were collected for analysis.Result: BGs were done at least every 3 to 6 h for the first 48 to 96 h of life, then every 6 to 24 h thereafter, as long as infants remained on hyperalimentation. Hyperglycemia was defined as mild (BG 151 to 180), moderate (181 to 210) or severe (>210). Insulin use (given if BG>180 to 210) was also noted for each simultaneous BG. ROP was classified as none, mild (stage 1 to 2) or severe (stage 3 to 4). Growth velocity (g kg À1 per day), length and head circumference were also analyzed. In all, 372 infants mean (s.d.) gestational age 27.6 (1.4) weeks, mean (s.d.) birth weight 994 (242) g had 18 649 BGs analyzed. 103 (28%) of the infants had mild ROP and 29 (8%) had severe ROP. 137 (37%) of the infants received at least 1 day of exogenous insulin (median days 9, range 1 to 26). Higher cumulative mean BG, more episodes of HG, and more insulin exposure were associated with an increased incidence and severity of ROP. Ordinal logistic regression identified lower gestational age, male gender, fetal growth restriction, slower NICU growth velocity, and higher BG as predictors for severity of ROP. However, insulin use was a stronger predictor than BG, and replaced it in the risk model.
Conclusion:After adjusting for important risk factors, HG and especially insulin use in premature infants may increase the risk of ROP. In addition, slower NICU growth velocity, but not rates of head or length growth, was predictive of ROP.
Conclusions: These data strongly support the need for a more detailed exploration of hsp60 mRNA levels in maternal circulation with the view toward routine assessment into everyday practice, and recognition as potential non-invasive biomarker for placental insufficiency related pregnancy complications.
OP25.03Effects of hypoxia on plasma amino acids and taurine of ovine fetuses in comparison to cerebral blood flow using 3D colour Doppler imaging Objectives: To assess the impact of changes in systemic venous returns (decreased inferior vena cava and relative increase in superior vena cava flows) on respective ventricular performances and O 2 transport to the brain. Methods: In this prospective multicenter study, the aortic Isthmic Systolic Index (ISI = systolic nadir divided by the peak velocity of the waveform) and the Isthmic Time Systolic Index (ITSI = duration of systolic reverse flow divided by the total time of systolic ejection) were measured weekly in a cohort of growth restricted fetuses and compared to a population of normals. Pulsatility indices of the umbilical (UPI) and middle cerebral arteries (MCAPI) were also calculated. Data were analyzed by ANOVA for mean comparison and partial correlations, corrected for gestational age using SPSS 20.0. Results: Sixty-two (62) IUGR fetuses between 24 and 37 weeks of gestation were compared to a population of normals, matched for gestational age. The systolic nadir of the AoI started to be retrograde at 26w in the IUGR group, compared to 31w in the normals. From 29w, the ISI became significantly lower in the IUGR group (F = 9.61, p = 0.021); this difference remained significant up to 32w. The ITSI was significantly correlated to the MCAPI (r = −0.36, p = 0.008). Conclusions: With the appearance of a reverse flow in the isthmus of IUGR fetuses, the brain is partly perfused by poorly oxygenated red cells turning in circle, both in systole and diastole. From the aortic isthmus towards aortic arch, brain, superior vena cava, right atrium and ventricle, ductus arteriosus and back to the isthmus, without the benefit of passing through the placenta. The relation between this ''isthmic-brain hypoxic circle'' and the incidence of abnormal post-natal neurodevelopmental sequellae deserves further investigations.This investigation (Placental Insufficiency and Aortic isthmus flow, The PIAF study) was supported by a research grant from the Canadian Institute for Health Research (CIHR); grant#MOP-97986.
OP25.05Corpus callosum differences assessed by MRI in term small for gestational age fetuses and its association with neurobehaviour G. Egaña-Ugrinovic, M. Sanz-Cortes, C. Couve-Pérez, F. Figueras, E. Gratacós Maternal Fetal Medicine, Hospital Clinic: Universitat de Barcelona, Barcelona, Spain Objectives: To evaluate corpus callosum (CC) morphometry by MRI in term small for gestational age (SGA) fetuses compared to controls and its association with neurobehavioral outcome. Methods: 117 SGA and 73 control fetuses with normal umbilical Doppler were imaged using a 3T MRI sca...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.