Study to evaluate the relation between weight gain in infants and occurrence of retinopathy of prematurity

Abstract

Purpose: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Capturing serial daily postnatal weight gain can act as an innovative, low-cost method of risk stratification. We aim to study the relation between weight gain in infants and occurrence of ROP. Methods: The prospective, observational study was conducted on 62 infants. ROP screening was done based on the Rashtriya Bal Swasthya Karyakram (RBSK) criteria. Infants were classified into no ROP ( n = 28), mild ROP ( n = 8), and treatable ROP ( n = 26) groups. Average daily postnatal weight gain was measured and its relation to development of ROP was studied. All statistical calculations were done using Statistical Package for the Social Sciences (SPSS) 21 version (SPSS Inc., Chicago, IL, USA) statistical program for Microsoft Windows. Results: Mean rate of weight gain in no ROP group, mild ROP group, and treatable ROP group was 33.12, 27.19, and 15.31 g/day, respectively ( P = 0.001). Mean gestational age and birth weight in treatable group ( n = 26) were 31.38 weeks and 1572.31 g, respectively. Receiver operating curve analysis revealed a cutoff of 29.33 g/day for ROP and 21.91 g/day for severe ROP. Conclusion: We concluded that, babies with poor weight gain of below 29.33 g/day are at high risk for ROP and babies with wight gain of 21.91 g/day are at high risk for severe ROP. These babies should be followed meticulously. So, the rate of weight gain of a preterm can help us to prioritize babies.

Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation

“…In our NEC cohort, the weight z scores and weight for length percentiles were signi cantly lower at 36 weeks corrected gestational age for the preterm infants with severe ROP. As reported in published reports, the poor weight gain postnatally has been associated with severe ROP [31][32][33]. Postnatal weight gain is a surrogate indicator of insulin-like growth factor 1 (IGF-1), and a persistent lower serum IGF-1 in preterm infants is associated with poor weight gain [34].…”

“…Poor weight gain postnatally shares a known association with severe ROP. [33][34][35] Given that poor postnatal weight gain is linked to persistently low serum IGF-1 in preterm infants, it is conceivable that the poor weight experienced in infants with NEC is a marker for retinal IGF-1 insufficiency and the resultant incomplete VEGF signaling aberrant vascular development of ROP. 36 The presence and timing of NEC requiring surgery is a significant risk factor for ROP development in preterm infants.…”

“…In this cohort, the weight z scores and weight for length percentiles were significantly lower at 36 weeks corrected gestational age for the preterm infants with severe ROP. Poor weight gain postnatally shares a known association with severe ROP [33][34][35]. Given that poor postnatal weight gain is linked to persistently low serum IGF-1 in preterm infants, it is conceivable that the poor weight experienced in infants with NEC is a marker for retinal IGF-1 insufficiency and the resultant incomplete VEGF signaling aberrant vascular development of ROP [36].…”

Usefulness of Children’s Hospital of Philadelphia ROP (CHOP ROP) model in the prediction of type 1 ROP

“…[ 3 4 ] Indian babies with a weight gain of <21.9 g/day may be at high risk of severe ROP. [ 5 ] A well-developed postnatal weight gain-based model could potentially improve the detection of ROP with less subjectivity while greatly reducing unnecessary examinations for lower-risk infants and improving resource allocation, particularly in settings with limited resources and a high burden of ROP in India—currently in its third ROP epidemic. [ 6 ]…”