Am J Perinatol. 2024 Apr 2. doi: 10.1055/a-2297-8644. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to identify the clinical and growth parameters associated with retinopathy of prematurity (ROP) in infants with necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP).
METHODS: We conducted a retrospective cohort study that compared clinical data before and after NEC/SIP onset in neonates, categorizing by any ROP and severe ROP (Type 1/2) status.
RESULTS: The analysis included one hundred and nine infants (n=109) with surgical necrotizing enterocolitis/SIP. Sixty infants (60/109, 55%) were diagnosed with any ROP, 32/109 (29.3%) infants (22% Types 1 and 7.3% Type 2) with severe ROP. On univariate analysis, those with severe ROP(32/109, 39.5%) were of lower median gestational age (23.8 weeks [23.4;24.6] vs. 27.3 [26.3;29.], p=<0.001), lower median birth weight (625 grams [512;710] vs.935 [700;1180]; p<0.001) and experienced higher exposure to clinical chorioamnionitis (22.6% vs. 2.13%; p=<0.006), and later median onset of ROP diagnosis (63.0 days [47.0;77.2] vs. 29.0 [19.0;41.0]; p=<0.001), received Penrose drain placement more commonly (19 (59.4%) vs.16 (34.0%); p=0.04), retained less residual small bowel (70.0 cm [63.1;90.8] vs.90.8 [72.0;101]; p=0.007) following surgery, were exposed to higher FiO2 seven days after birth (p=0.001), received ventilation longer and exposed to higher FiO2 at two weeks (p <0.05) following NEC and developed acute kidney injury (AKI) more often (25 (86.2%) vs.20 (46.5%); p= 0.002) than those without ROP. Those with severe ROP had lower length, weight for length, and head circumference z scores. In an adjusted Firth’s logistic regression, GA (aOR=0.51, 95% CI: [0.35, 0.76]) and diagnosis at later age (aOR=1.08, 95% CI: [1.03, 1.13]) was shown to be significantly associated with any ROP.
CONCLUSION: Infants who develop severe ROP following surgical NEC/SIP are likely to be younger, smaller, have been exposed to more O2, develop AKI, and grow poorly compared to those did not develop severe ROP.
PMID:38565196 | DOI:10.1055/a-2297-8644
