Association of Severe Retinopathy of Prematurity and Postnatal Weight Gain at Chiang Mai University Hospital



ชื่องานวิจัย

ความสัมพันธ์ระหว่างการเพิ่มของน้ำหนักตัวหลังเกิด และการเกิดจอประสาทตาผิดปกติระดับรุนแรงในทารกเกิดก่อนกำหนดน้ำหนักตัวน้อยมากที่โรงพยาบาลมหาราชนครเชียงใหม่


ผู้วิจัย

พญ.อนัญญา วงศ์นพหิรัญ

Abstract

Objectives: To identify an association of weight gain and severe retinopathy of prematurity (ROP) in Thai preterm infants with birth weight of less than 1,500 g. (very low birth weight; VLBW)

Method: A retrospective cohort study was performed by reviewing patient’s electronic charts.  VLBW infants admitted in the NICU during June 2014 and December 2016 and obtained ROP screening by ophthalmologists were enrolled. Relative weight gain (RWG) were calculated and compared between group of non ROP/mild ROP and severe ROP requiring surgery.

Results: One hundred and thirty-nine infants were included in this study. The incidence of ROP was 33.1% (46/139), of which 17.3% (24/139) were severe ROP requiring surgery. Compared with the infants with no ROP/mild ROP, the infants with severe ROP requiring surgery had lower median birth weight (840 vs. 1,195 g, P<0.001) and lower gestational age (27 vs.30 wk., P<0.001). RWG of the severe ROP requiring surgery infants were significantly lower at the 2nd and 4th week of age. Multivariate logistic regression analysis demonstrated that birth weight and RWG at the 2nd week of age were associated with severe ROP requiring surgery. The cut-off level of RWG was 4.21 g/kg/day for predicting severe ROP requiring surgery with sensitivity and specificity of 79.2% and 53%, respectively. (AUC =0.695, 95% CI 0.58 to 0.81, P<0.05)      

Conclusion: In addition to birth weight, poor weight gain and total caloric intake at the 2nd wk. of age associated with severe ROP requiring surgery. Aggressive nutritional management and careful weight gain monitoring during the first 2 week may improve the outcome of ROP. 

Key words: retinopathy of prematurity, surgery, very low birth weight, relative weight gain, total caloric intake

 

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