Relationship between severe bronchopulmonary dysplasia and severe retinopathy of prematurity in premature newborns

Singh, Jasleen; Wymore, Erica; Wagner, Brandie D.; Thevarajah, Tamara S.; Jung, Jennifer; Kinsella, John P.; Palestine, Alan G.; Lynch, Anne M.

doi:10.1016/j.jaapos.2019.02.008

Cited by 19 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, these findings suggest that quality improvement of perinatal and neonatal intensive care as evidenced by improved survival of peri-viable infants at 23-24 weeks' gestation could not only improve survival but also reduce morbidity rates of extremely preterm infants 7,28,30,31,33 . Given that oxygen toxicity increases the risk of death, BPD and ROP in the premature infants [3][4][5][6]29,34,35 , the controversial association of decreased ROP, BPD and survival observed in the lower oxygen saturation setting of 85-89%, and the increased ROP, BPD and survival observed in the higher oxygen saturation setting of 91-95% [12][13][14][15][16][17][18][19][20][21][22][23][24] is difficult to explain. For international comparison of neonatal research networks, the Japanese neonatal research network with the highest survival rate and proportion of infants at 24 weeks' gestation reported the highest BPD and ROP treatment rates, whereas the Swiss neonatal network with a low survival and proportion of infants at 24 weeks' gestation reported the lowest BPD and ROP treatment rates 2,25 .…”

Section: Discussionmentioning

confidence: 99%

“…Given that oxygen toxicity increases the risk of death, BPD and ROP in the premature infants 3 – 6 , 29 , 34 , 35 , the controversial association of decreased ROP, BPD and survival observed in the lower oxygen saturation setting of 85–89%, and the increased ROP, BPD and survival observed in the higher oxygen saturation setting of 91–95% 12 – 24 is difficult to explain. For international comparison of neonatal research networks, the Japanese neonatal research network with the highest survival rate and proportion of infants at 24 weeks’ gestation reported the highest BPD and ROP treatment rates, whereas the Swiss neonatal network with a low survival and proportion of infants at 24 weeks’ gestation reported the lowest BPD and ROP treatment rates 2 , 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Increased oxidative stress is a causative factor for increased mortality and morbidities such as bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in very low birth weight infants (VLBWIs) [1][2][3][4][5][6][7] . Hence, the controversial association between improved survival and increased rates of ROP and BPD with higher oxygen saturation targets of 91-95% that have been observed in several randomized trials and meta-analyses [8][9][10][11][12][13][14][15][16][17][18][19][20] is difficult to explain.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Survival rate dependent variations in retinopathy of prematurity treatment rates in very low birth weight infants

Park

Hwang

Chang

et al. 2020

Sci Rep

View full text Add to dashboard Cite

As increased oxidative stress causes increased mortality and morbidities like bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in very low birth weight infants (VLBWIs), the conundrum of improved survival but increased ROP observed with the high oxygen saturation target range of 91–95% is difficult to explain. To determine the survival rate-dependent variation in ROP treatment rate, 6292 surviving eligible VLBWIs registered in the Korean Neonatal Network were arbitrarily grouped according to the survival rate of infants at 23–24 weeks’ gestation as group I (> 70%, n = 1626), group II (40–70%, n = 2984) and group III (< 40%, n = 1682). Despite significantly higher survival and lower BPD rates in group I than in groups II and III, the ROP treatment rate was higher in group I than in groups II and III. However, the adjusted odds ratios for ROP treatment were not significantly different between the study groups, and the ROP treatment rate in the infants at 23–24 weeks’ gestation was 21-fold higher than the infants at ≥ 27 weeks’ gestation. The controversial association between improved survival and reduced BPD reflecting quality improvement of neonatal intensive care but increased ROP treatment rate might be primarily attributed to the improved survival of the most immature infants.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Survival rate dependent variations in retinopathy of prematurity treatment rates in very low birth weight infants

Park

Hwang

Chang

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…These severe neonatal morbidities frequently co-occur among premature infants and have some shared risk factors and pathophysiology. For instance, preterm infants with severe BPD are more likely to have severe ROP compared to infants without BPD [ 4 ], and both of these health complications may be influenced by altered regulation of angiogenic and/or angiostatic factors [ 5 ]. Additionally, severe ROP tends to occur in infants that have brain injury and impaired mental and psychomotor development [ 6 ], which may be partly due to prenatal and neonatal infections and prolonged inflammatory responses [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Serious neonatal morbidities are associated with differences in DNA methylation among very preterm infants

et al. 2020

View full text Add to dashboard Cite

Background Infants born very preterm are more likely to experience neonatal morbidities compared to their term peers. Variations in DNA methylation (DNAm) associated with these morbidities may yield novel information about the processes impacted by these morbidities. Methods This study included 532 infants born < 30 weeks gestation, participating in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants study. We used a neonatal morbidity risk score, which was an additive index of the number of morbidities experienced during the NICU stay, including bronchopulmonary dysplasia (BPD), severe brain injury, serious neonatal infections, and severe retinopathy of prematurity. DNA was collected from buccal cells at discharge from the NICU, and DNAm was measured using the Illumina MethylationEPIC. We tested for differential methylation in association with the neonatal morbidity risk score then tested for differentially methylated regions (DMRs) and overrepresentation of biological pathways. Results We identified ten differentially methylated CpGs (α Bonferroni-adjusted for 706,278 tests) that were associated with increasing neonatal morbidity risk scores at three intergenic regions and at HPS4, SRRD, FGFR1OP, TNS3, TMEM266, LRRC3B, ZNF780A, and TENM2. These mostly followed dose–response patterns, for 8 CpGs increasing DNAm associated with increased numbers of morbidities, while for 2 CpGs the risk score was associated with decreasing DNAm. BPD was the most substantial contributor to differential methylation. We also identified seven potential DMRs and over-representation of genes involved in Wnt signaling; however, these results were not significant after Bonferroni adjustment for multiple testing. Conclusions Neonatal DNAm, within genes involved in fibroblast growth factor activities, cellular invasion and migration, and neuronal signaling and development, are sensitive to the neonatal health complications of prematurity. We hypothesize that these epigenetic features may be representative of an integrated marker of neonatal health and development and are promising candidates to integrate with clinical information for studying developmental impairments in childhood.

show abstract

“…Although such efforts are gradually delineating the best practices for maximizing preterm infant visual outcomes, there is yet no clinical consensus regarding protocols and target ranges for preterm oxygen therapy, which is particularly true in developing countries with the greatest disease burden [4,[54][55][56]. Various co-morbidities that impact systemic oxygenation such as bronchopulmonary dysplasia [57,58], thrombocytopenia [59], and anemia [60,61] are also associated with ROP development and/or severity. Interventions targeting these co-morbid conditions, such as transfusion, often show association with more severe ROP disease, though this is likely a surrogate indicator of hypoxia as the etiologic factor [62].…”

Section: Preventive Interventions Informed By Rop Molecular Pathogenementioning

confidence: 99%

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

Carroll

Owen

2020

Exploration of Medicine

View full text Add to dashboard Cite

Retinopathy of prematurity (ROP) is a blinding morbidity of preterm infants, which represents a significant clinical problem, accounting for up to 40% of all childhood blindness. ROP displays a range of severity, though even mild disease may result in life-long visual impairment. This is complicated by the fact that our current treatments have significant ocular and potentially systemic effects. Therefore, disease prevention is desperately needed to mitigate the life-long deleterious effects of ROP for preterm infants. Although ROP demonstrates a delayed onset of retinal disease following preterm birth, representing a potential window for prevention, we have been unable to sufficiently alter the natural disease course and meaningfully prevent ROP. Prevention therapeutics requires knowledge of early ROP molecular changes and risk, occurring prior to clinical retinal disease. While we still have an incomplete understanding of these disease mechanisms, emerging data integrating contributions of maternal/placental pathobiology with ROP are poised to inform novel approaches to prevention. Herein, we review the molecular basis for current prevention strategies and the clinical outcomes of these interventions. We also discuss how insights into early ROP pathophysiology may be gained by a better understanding of maternal and placental factors playing a role in preterm birth.

show abstract

Relationship between severe bronchopulmonary dysplasia and severe retinopathy of prematurity in premature newborns

Cited by 19 publications

References 30 publications

Survival rate dependent variations in retinopathy of prematurity treatment rates in very low birth weight infants

Survival rate dependent variations in retinopathy of prematurity treatment rates in very low birth weight infants

Serious neonatal morbidities are associated with differences in DNA methylation among very preterm infants

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

Contact Info

Product

Resources

About