Late postnatal systemic steroids predispose to retinopathy of prematurity in very‐low‐birth‐weight infants: a comparative study

Smolkin, Tatiana; Steinberg, M.; Sujov, Polo; Mezer, Eedy; Tamir, Ada; Makhoul, Imad R.

doi:10.1111/j.1651-2227.2008.00629.x

Cited by 24 publications

(13 citation statements)

References 30 publications

(46 reference statements)

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“…Seiberth et al , Karna et al and Hoogerwerf et al demonstrated that duration of AV is a risk factor for (severe) ROP 6 10 11. Treatment with dopamine was a risk factor for (severe) ROP in studies of Mizoguchi et al and Liu et al 12 13 Hoogerwerf et al , Smolking et al and the systematic review of the Cochrane database showed that (late) treatment with postnatal steroids is a risk factor for ROP 6 14 15. Lee, Chen et al , Weintraub et al and Jensen et al demonstrated perinatal infection/inflammation or sepsis to be a risk factor for (severe) ROP 16 – 19.…”

Section: Discussionmentioning

confidence: 99%

Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria

et al. 2013

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Aims To develop a new national screening guideline for retinopathy of prematurity (ROP). Methods Included were infants of the 2009 prospective ROP inventory in The Netherlands with gestational age (GA) <32 weeks and/or birth weight (BW) <1500 g. Five models were studied, based on GA and BW in combination with no, one or a set of five risk factors for ROP. Risk factors were determined by logistic regression. In MEDLINE and EMBASE, additional risk factors were searched. A precondition was that no infants with severe ROP would be missed. Receiver operating characteristic curves or classical measures were used to determine diagnostic accuracy. Results The model including all infants with severe ROP comprised screening of infants with GA <30 weeks and/or BW <1250 g and a selection of infants with GA 30-32 weeks and/or BW 1250-1500 g, with at least one of the following risk factors: artificial ventilation (AV), sepsis, necrotising enterocolitis (NEC), postnatal glucocorticoids or cardiotonica. This model would not detect 4.8% (95% CI 2.5% to 8.0%) of infants with mild ROP and would reduce infants eligible for screening by 29%. Conclusions In The Netherlands, screening may be safely reduced using a new guideline based on GA, BW, AV, sepsis, NEC, postnatal glucocorticoids and cardiotonica.

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Section: Discussionmentioning

confidence: 99%

Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria

et al. 2013

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“…6,35 In addition to glucose status, which has been already discussed above, other factors such as exposure to higher mean airway pressure with prolonged mechanical ventilation, 10,36 inotrope therapy, 10,36,37 and postnatal steroid administration 1,38 as well the presence of a PDA, 39 BPD, 39 sepsis 37 and IVH 10 have been also linked to ROP development. Severity of illness is suspected to have a major role in the development of ROP, and potentially explains some of the significant associated factors.…”

Section: Abnormal Glucose Levels In Elbw Infantsmentioning

confidence: 99%

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

et al. 2011

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Objective: The objective of this study is to investigate the relationship between glycemic status and severe retinopathy of prematurity (ROP).Study Design: This is a retrospective cohort study of 114 infants <1000 g admitted to a level IV neonatal intensive care unit within 48 h of life. A cumulative, time-weighted glucose level (TWGL) derived from plotting glucose values over time was included in logistic regression analysis to identify predictors for severe ROP.Result: Infants had 26.6 ± 2 weeks gestational age and had a birth weight of 782±136 g. TWGL during first 10 and 30 days of life were greater in the severe ROP group (P<0.01). Unlike single events of glucose levels X150 mg dl À1 , 10 days TWGL X100 mg dl À1 (odds ratio (OR) 5.2, P<0.02) and 30 days TWGL X118 mg dl À1 (OR 5.7, P<0.02) were predictors for severe ROP (univariate). Multivariate regression confirmed 30 days TWGL X118 mg dl À1 (OR 9.4 to 10) and gram-positive sepsis (OR 4.1 to 5) as predictors for severe ROP (P<0.05). Conclusion:High overall glycemic status is associated with the development of severe ROP.

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“…Most recent reports point out the presence of normal cerebral development in only 23.5% of VLBW newborns, confirming global, mental and psychomotor retardation in the remaining group with the lack of systemic steroids application [17]. Contrary to that, other data in the literature also underline that the majority of prematures exposed to Dexamethasone in BPD do not develop cerebral palsy or global developmental disability, nevertheless one cannot exclude other more subtle adverse effects after steroids in further periods of childhood [1,8,29,30,[33][34][35].…”

Section: Discussionmentioning

confidence: 94%

“…This pathology is a biphasic process consisting of an initial phase of blunted vascular growth followed by a second phase of vasoproliferation that may be recognized by ophthalmoscopy 6 to 8 wks after birth [1]. Fundamental initiating process involved in retinal vascular development is angiogenesis which is regulated by growth factors, extracellular matrix components and complex of anti-and pro-inflammatory cytokines, among which IL-6, CRP, IL-17, IL-18, TNFα, TGF-β, BDNF, NT4, PDGF, IGF-I, EGF, FGF, PKC -protein kinase C-and HIF-1 α are recognized as key factors in the development of ROP.…”

Section: Introductionmentioning

confidence: 99%

Early Experience with Diode Laser Combined with Systemic Steroid Therapy for Severe Stages of Retinopathy of Prematurity

Modrzejewska¹,

Lachowicz²,

D³

et al. 2014

J Steroids Hormon Sci

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Citation: Modrzejewska M, Lachowicz E, Joanna Kot D, Lubiński W, Rudnicki J, et al. (2014) AbstractAims: To study the efficacy of diode laser-systemic steroid therapy in extremely and very-low-birth-weight prematures with severe Retinopathy of Prematurity (ROP).Methods: 36 eyes of 18 prematures, mean gestational age 25.67 weeks (SD ± 1.28) and 811, 83 g birth weight (SD ± 299.08) with aggressive-posterior ROP (AP-ROP) and threshold 3 ROP with plus sign and Extraretinal Fibrovascular Proliferation (EFP) were enrolled. Indirect diode laser combined with intravenous course of Dexamethason was applied. Analyzed risk factors were correlated with the same ones received in cohort treated only with laser. Shapiro-Wilk, t-Student, U Mann-Whitney tests were involved in the statistical analysis (significance levels at p<0.05).Results: Favorable anatomical results after mean 11.29 (SD ± 2.29) days of therapy were noted in 32 eyes (88.88%), ROP 5 developed in four eyes, but this difference was statistically non-significant (p=0.0612). Transient cortisol decreasing, hyperglycemia and partial adrenal fatigue were noted in some babies. During therapy, arterial systolic and diastolic pressures rose (p<0.05; p<0.01), significantly, which were related with severity of ROP, such as, C-reactive protein, erythrocyte and hematocrit, ventilation duration and number of transfusion (p<0.01).

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Late postnatal systemic steroids predispose to retinopathy of prematurity in very‐low‐birth‐weight infants: a comparative study

Abstract: Significantly more neonates in the ROP group received late postnatal systemic steroids as compared to controls. We speculate that steroids, by altering insulin growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) expression, might contribute to the pathogenesis of ROP.

Cited by 24 publications

References 30 publications

Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria

Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria

Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

Early Experience with Diode Laser Combined with Systemic Steroid Therapy for Severe Stages of Retinopathy of Prematurity

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