Purpose:
Recent studies suggest combining repeated insulin-like growth factor levels and weekly weight gain data in the first month of life in infants can identify those at risk for sight-threatening retinopathy of prematurity (ROP) earlier and more specifically. We sought to determine if using birth weight, total weight change over 30 days and gestational age alone would reliably predict the development of ROP requiring treatment. In addition, we looked at daily weight gain trends in the first month of life to find possible earlier and more specific alarms for the development of threshold ROP.
Methods:
A retrospective chart review of all infants born during 2005-2008 at Loyola University Medical Center (LUMC), meeting institutional guidelines for funduscopic screening was implemented. Gestational age (GA), birth weight (BW), and total weight change (TWC) over the first 30 days of life was recorded. We also compared the post-natal daily weight trends of those that required laser intervention with those that did not. Statistical analysis including T-test and trend analysis were used. Infants with reasons for artificial weight gain such as congestive heart failure, non-immune hydrops, and hydrocephalus were excluded.
Results:
20 of 212 (9.4%) of infants who met screening guidelines required laser intervention for threshold ROP. All measures (GA, BW, TWC) were found to be statistically significant in predicting progression to threshold ROP with values listed in table 1. In the first 30 days of life, infants that required laser only gained 38% of their birth weight compared to 42% for those that did not require laser.
Conclusions:
The combination of post-natal weight change over 30 days, birth weight and gestational age can serve as accurate noninvasive predictors for the development of visually significant ROP in infants. Analyzing trends in the daily post-natal weight change may also be valuable in developing earlier, more selective indicators that allow for possible sight-saving intervention.
Keywords: retinopathy of prematurity • clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: health care delivery/economics/manpower