Late-onset Circulatory Collapse and Continuous Positive Airway Pressure are Useful Predictors of Treatment-requiring Retinopathy of Prematurity: A 9-year Retrospective Analysis

Arima, Mitsuru; Tsukamoto, Shoko; Fujiwara, Kohta; Murayama, Miwa; Fujikawa, Kanako; Sonoda, Koh Hei

doi:10.1038/s41598-017-04269-5

Cited by 10 publications

(6 citation statements)

References 40 publications

(55 reference statements)

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“…In a study from the United States, CPAP was not investigated as an independent variable but as part of respiratory support in univariate analysis, and the proportion of patients on CPAP support on day 28 was similar between the TR-ROP and non-TR-ROP groups (12% vs. 10%) 25 . Similarly, in a single-center study in Japan, use of CPAP at 35 weeks of postmenstrual age was reported as an independent factor for predicting TR-ROP among infants with ROP (OR 4.50) 32 . Unlike these previous reports, our study identified the duration of CPAP as a protective factor for TR-ROP.…”

Section: Discussionmentioning

confidence: 78%

Long use of continuous positive airway pressure protects against the development of treatment-requiring retinopathy of prematurity

Suga

Kyono

Kido

et al. 2022

Sci Rep

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Although preterm infant mortality is low, the proportion of patients with treatment-requiring retinopathy of prematurity (TR-ROP) is high in Japan. Various multicenter studies have reported the risk factors for TR-ROP; however, no large-scale studies have been conducted in Japan. We retrospectively analyzed 13,645 infants born at < 28 weeks’ gestation (January 1, 2009–December 31, 2018), and registered in the Neonatal Research Network of Japan database. TR-ROP was defined as ROP requiring retinal laser photocoagulation and/or intravitreal anti-vasoendothelial growth factor drugs. Multivariable logistic regression analysis was performed to identify factors associated with TR-ROP development. The median gestational age of enrolled infants was 26 weeks (interquartile range [IQR], 24–27 weeks), median birth weight was 760 g (IQR, 620–918 g). Proportion of patients with TR-ROP was 30.3%. TR-ROP was significantly associated with birth at < 26 weeks’ gestational age (adjusted odds ratio [aOR] 1.54), blood transfusion (aOR 1.49), invasive ventilation ≥ 28 days (aOR 1.41), sepsis (aOR 1.29), birth weight < 750 g (aOR 1.28), intraventricular hemorrhage (aOR 1.33), delayed achievement of full enteral feeding > 14 days (aOR 1.28), and continuous positive airway pressure (CPAP) therapy ≥ 28 days (aOR 0.79). Supplemental oxygen ≥ 28 days was not associated with TR-ROP development. Lower gestational age at birth and birth weight, blood transfusion, prolonged invasive ventilation, sepsis, intraventricular hemorrhage, and delayed achievement of full enteral feeding were risk factors for TR-ROP, whereas CPAP use was protective against TR-ROP.

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Section: Discussionmentioning

confidence: 78%

Long use of continuous positive airway pressure protects against the development of treatment-requiring retinopathy of prematurity

Suga

Kyono

Kido

et al. 2022

Sci Rep

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“…The course of many stage 3 zone Ⅰ ROP may be shorter than that of only one week, and sometimes some mild ROP may be missed. Some researchers have proposed that treatment-requiring ROP, stage 3 ROP, and zone I and II disease are related to mechanical ventilation time [5,[16][17] . A study from Japan reported invasive ventilation ≥28d is a risk factor of treatment-requiring ROP [18] .…”

Section: Resultsmentioning

confidence: 99%

Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population

Li¹,

Cai²,

Yang³

2022

Int J Ophthalmol

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AIM: To investigate the ratio of spontaneous regression of retinopathy of prematurity (ROP) and to explore the possible relevant predictive factors. METHODS: A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected. Stage, zone, and duration of ROP were recorded. Statistical analysis was performed on 51 possible predictive factors. RESULTS: Totally 356 infants showed spontaneous regression. The incidence was 100%, 95.3%, and 22.7% in stage 1, 2, and 3, respectively. The 13.4% of the ROP with plus disease eventually resolved spontaneously. All affected eyes of aggressive posterior retinopathy of prematurity (AP-ROP) failed to spontaneously regress. The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP. Days of mechanical ventilation (OR=0.981, 95%CI, 0.965-0.997, P=0.021), retinal hemorrhage (OR=0.173, 95%CI, 0.064-0.470, P=0.001), delivery pattern (OR=2.750, 95%CI, 1.132-6.681, P=0.025), maternal anemia in pregnancy (OR=0.142, 95%CI, 0.036-0.563, P=0.005), the stages (at initial diagnosis OR=0.183, 95%CI, 0.041-0.816, P=0.026; at final diagnosis OR=0.031, 95%CI, 0.006-0.167, P<0.001), and with plus disease or not (OR=0.005, 95%CI, 0.001-0.031, P<0.001) were independent predictive factors of the spontaneous regression of ROP. CONCLUSION: Most mild ROP can spontaneously resolve. Active treatment is still recommended for stage 3 ROP, zone I ROP, AP-ROP, and ROP with plus disease. Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution. The pattern of delivery and the mother’s anemia during pregnancy can also affect the prognosis of ROP.

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“…Both independent of and cumulatively with oxygen exposure, positive pressure ventilation is an important modifiable risk factor for severe ROP [ 41 , 42 , 43 , 44 , 45 ]. The duration of mechanical ventilation is a risk factor for ROP development [ 46 , 47 ], and several studies have confirmed prolonged mechanical ventilation as an independent risk factor for ROP [ 48 , 49 , 50 , 51 , 52 , 53 ].…”

Section: Perinatal and Neonatal Risk Factorsmentioning

confidence: 99%

Modifiable Risk Factors and Preventative Strategies for Severe Retinopathy of Prematurity

Prasad

Ingolfsland

Christiansen

2023

Life

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Severe ROP is characterized by the development of retinal fibrovascular proliferation that may progress to retinal detachment. The purpose of this report is to review five of the most common and well-studied perinatal and neonatal modifiable risk factors for the development of severe ROP. Hyperoxemia, hypoxia, and associated prolonged respiratory support are linked to the development of severe ROP. While there is a well-established association between clinical maternal chorioamnionitis and severe ROP, there is greater variability between histologic chorioamnionitis and severe ROP. Neonatal sepsis, including both bacterial and fungal subtypes, are independent predictors of severe ROP in preterm infants. Although there is limited evidence related to platelet transfusions, the risk of severe ROP increases with the number and volume of red blood cell transfusions. Poor postnatal weight gain within the first six weeks of life is also strongly tied to the development of severe ROP. We also discuss preventative strategies that may reduce the risk of severe ROP. Limited evidence-based studies exist regarding the protective effects of caffeine, human milk, and vitamins A and E.

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Late-onset Circulatory Collapse and Continuous Positive Airway Pressure are Useful Predictors of Treatment-requiring Retinopathy of Prematurity: A 9-year Retrospective Analysis

Cited by 10 publications

References 40 publications

Long use of continuous positive airway pressure protects against the development of treatment-requiring retinopathy of prematurity

Long use of continuous positive airway pressure protects against the development of treatment-requiring retinopathy of prematurity

Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population

Modifiable Risk Factors and Preventative Strategies for Severe Retinopathy of Prematurity

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