Severe retinopathy of prematurity is associated with early post-natal low platelet count

Abstract

Pathophysiology of retinopathy of prematurity (ROP) still presents a gap. Lately blood tests parameters of premature infants have been measured at different times of ROP, attempting to detect correlations with ROP development and progression. So far, very early post-natal biomarkers, predictive of ROP outcome, have not been detected. Our purpose is to evaluate, in the earliest post birth blood sample, the correlation between routinely dosed blood parameters and ROP outcome. 563 preterm babies, screened according to ROP guidelines, were included and classified in conformity with ET-ROP study in “Group 1” (ROP needing treatment), “Group 2” (ROP spontaneously regressed) and “noROP” group (never developed ROP). The earliest (within an hour after delivery) blood test parameters routinely dosed in each preterm infant were collected. Platelet count was decreased in Group 1 versus noROP group (p = 0.0416) and in Group 2 versus noROP group (p = 0.1093). The difference of thrombocytopenic infants among groups was statistically significant (p = 0.0071). CRP was higher in noROP versus all ROPs (p = 0.0331). First post-natal blood sample revealed a significant thrombocytopenia in ROP needing treatment, suggesting a role of platelets in the pathophysiology and progression of ROP, possibly considering it as a predictive parameter of ROP evolution.

Association of platelet deficiency with severe retinopathy of prematurity: a review

“…Ultimately, 19 primary studies fulfilled the eligibility criteria and were included in this review: 18 clinical studies and one study with both experimental and clinical sections. All the clinical studies were observational, of which one case series, 17 eight retrospective case-control studies with or without matching, 15,[18][19][20][21][22][23][24] eight retrospective cohort studies, 16,[25][26][27][28][29][30][31] and two prospective cohort studies. 32,33 If studies comprised three groups, 24,27,29,30,33 comparative data were only collected on cases with ROP requiring treatment and the group of infants without ROP.…”

Novel Potential Biomarkers for Retinopathy of Prematurity

“…There is significant thrombocytopenia in the blood samples of infants with treatment-requiring ROP, and this could be a predictor of disease progression ( 103 ). Platelet mass index is a reliable monitoring indicator for the prognosis of ROP in very premature newborns ( 104 ).…”

Neurosensory Alterations in Retinopathy of Prematurity: A Window to Neurological Impairments Associated to Preterm Birth

“…Therefore, there is an urgent need of standardizing evaluation criteria and identifying early indicators for ROP development. In this respect, a recent retrospective Italian study reported that early platelet counts were significantly reduced in newborns who later developed severe ROP which required treatment, but not in those who never developed ROP [ 48 , 49 ] suggesting that platelet count may be used to detect in advance premature infants prone to ROP development. Recently, a new prediction model for ROP, the Postnatal Growth and ROP (G-ROP), which was originally developed in 2018 and validated in a North American cohort of preterm infants [ 50 ], has been also validated in Italy [ 51 ].…”