Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Acta Paediatr. 2011 Dec;100(12):1528-33. doi: 10.1111/j.1651-2227.2011.02394.x. Epub 2011 Jul 18.
To identify factors associated with poor early weight gain as reflected in an alarm system, WINROP, and risk of later proliferative retinopathy of prematurity (ROP) in infants with gestational age (GA) < 28 weeks.
Infants with a WINROP alarm and proliferative ROP, the 'alarm group' (n = 23), were matched to GA and gender to a 'no alarm group' (n = 23) with no WINROP alarm and no or mild ROP. Retrospectively maternal variables, birth characteristics and neonatal factors, during the first three postnatal weeks, were compared.
The 'alarm group' had lower birth weight (BW) and BW standard deviation score, longer stay in ventilator, more insulin and corticosteroid treatments, and lower white blood cell count. In a logistic regression model, BW standard deviation score, insulin, low white blood cell count, absence of both elevated C-reactive protein and premature rupture of membranes were associated with proliferative ROP and WINROP alarm (p = 0.000, r(2) = 0.704).
This study shows that prenatal factors resulting in low BW have persisting effects on early postnatal growth, metabolism and inflammatory response. Future prospective studies will focus on the link between these factors and pathological retinal vessel development in the early postnatal period to find possible preventive strategies.
确定与体重增长不良相关的因素，该因素反映在一个警报系统 WINROP 中，以及与胎龄（GA）<28 周的早产儿中增生性视网膜病变（ROP）的风险相关。
将具有 WINROP 警报和增生性 ROP 的婴儿（“警报组”，n=23）与 GA 和性别相匹配，分为“无警报组”（n=23），其没有 WINROP 警报，且没有或轻度 ROP。比较了出生后前 3 周的母体变量、出生特征和新生儿因素。
“警报组”的出生体重（BW）和 BW 标准差评分较低，呼吸机使用时间较长，胰岛素和皮质类固醇治疗更多，白细胞计数较低。在逻辑回归模型中，BW 标准差评分、胰岛素、白细胞计数低、C 反应蛋白升高和胎膜早破均与增生性 ROP 和 WINROP 警报相关（p=0.000，r(2)=0.704）。
本研究表明，导致 BW 降低的产前因素对新生儿早期的生长、代谢和炎症反应仍有持续影响。未来的前瞻性研究将集中于这些因素与出生后早期病理性视网膜血管发育之间的联系，以寻找可能的预防策略。
