Neonatal Bacteremia and Retinopathy of Prematurity

Abstract

To explore whether early or late and presumed or definite neonatal bacteremia are associated with an increased risk of severe retinopathy of prematurity (ROP). Methods:We evaluated 1059 infants born before week 28 of gestation for ROP. Infants were classified as having early (postnatal week 1) or late (weeks 2-4) definite (culture-proven) or presumed (antibiotics taken for Ͼ72 hours despite negative blood culture results) bacteremia. Severe ROP was defined as stage 3 to 5, zone 1, prethreshold/threshold, or plus disease. We used timeoriented risk models to adjust for confounders.Results: In univariable, but not multivariable, analysis, newborns with presumed early bacteremia were at increased risk for plus disease (odds ratio [OR], 1.7; 95% CI, 1.1-2.7), and those with definite early bacteremia were at increased risk for stage 3 to 5 disease (1.9; 1.1-3.2). Infants who had presumed or definite late bacteremia were at increased risk for all 4 indicators of severe ROP in univariable analysis. In multivariable analysis, newborns with presumed late bacteremia were at increased risk for prethreshold/threshold ROP (OR, 1.8; 95% CI, 1.02-3.2), and those with definite late bacteremia were at increased risk for prethreshold/threshold ROP (1.8; 1.1-2.9) and plus disease (1.8; 1.05-2.9).Conclusions: Definite late neonatal bacteremia seems to be an independent risk factor for prethreshold/threshold ROP and plus disease, and presumed late bacteremia seems to be related to prethreshold/threshold ROP.

Oxygen Monitoring Reduces the Risk for Retinopathy of Prematurity in a Mexican Population

“…Poor living conditions, teenage mothers and the quality of prenatal and postnatal care may affect survival rates. Growth restriction at birth, poor postnatal growth, insufficient nutritional support and neonatal comorbidities such as sepsis, bronchopulmonary dysplasia and necrotizing enterocolitis are risk factors for severe ROP that also depend to some extent on the quality of prenatal and postnatal care [7,20,21,22,23,24,25]. Thus, we conclude that WINROP performs less accurately in some populations of preterm infants and should be used with caution where inaccurate dating of GA may be suspected and/or discrepancies in the characteristics of the infants included, from whom WINROP was developed and validated (Sweden and North American).…”

Prediction of severe retinopathy of prematurity using the WINROP algorithm in a birth cohort in South East Scotland

“…Postnatal factors known to be associated with an increased risk of the development of severe ROP include infection25 and intraventricular haemorrhage 26. Ethnicity should also be considered in risk models 11…”

Interventions To Prevent Retinopathy of Prematurity: A Meta-analysis

“…These correlate well with the current understanding of ROP pathogenesis and include poor postnatal weight gain in the first 6 weeks of life, 4,5 hyperoxia, [6][7][8] exposure to packed red blood cell (PRBC) transfusions, 9,10 and late onset sepsis. [11][12][13] The objective of this meta-analysis was to study the effect and magnitude of the benefit of multiple interventions aimed at the prevention of ROP in preterm neonates <32 weeks gestational age. Four categories of interventions were selected based on the current understanding of ROP pathophysiology and included: (1) postnatal nutrition, (2) management of supplemental oxygen, (3) PRBC transfusions, and (4) infection reduction.…”