Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Eye (Lond). 2011 Nov;25(11):1478-83. doi: 10.1038/eye.2011.208. Epub 2011 Aug 26.
To determine the relative effect of birth weight and gestational age on retinopathy of prematurity (ROP) using preterm twin pairs discordant for birth weight.
This study was a retrospective cohort study including 55 consecutive twin pairs of 110 preterm infants (gestational age ≤33 weeks). The outcomes of ROP including occurrence (any stage), severe ROP (stage 3 or more), and clinically significant ROP requiring laser treatment were compared between twins with the lower birth weight from each pair and their co-twins with the higher birth weight. Using twin pairs having different birth weight and identical gestational age, the independent effects of prematurity and intrauterine growth on ROP could be evaluated. Other perinatal morbidities related to prematurity were also compared between twin pairs.
No significant differences in ROP between larger and smaller infants were observed in the twin-paired analysis while analysis on individual infants showed strong association between small birth weight and ROP outcomes. However, in both the larger and smaller infant groups, gestational age of <28 weeks was significantly associated with ROP outcomes. No differences were found between twin pairs regarding other perinatal morbidities including bronchopulmonary dysplasia, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, and periventricular leukomalacia.
Birth weight is not associated with ROP, while gestational age is in the twin-paired study, suggesting that gestational age is a better predictor of ROP than birth weight. This indicates that maturity is more important in the pathogenesis of ROP than intrauterine growth.
通过比较出生体重不同的早产双胞胎，来确定出生体重和胎龄对早产儿视网膜病变（ROP）的相对影响。
这是一项回顾性队列研究，纳入了 55 对连续的 110 例（胎龄≤33 周）早产双胞胎。比较每对双胞胎中出生体重较低的婴儿与其出生体重较高的同胞的 ROP 结局，包括ROP 的发生（任何阶段）、严重 ROP（3 期及以上）和需要激光治疗的临床显著 ROP。通过比较出生体重不同但胎龄相同的双胞胎，可以评估早产和宫内生长对 ROP 的独立影响。还比较了与早产相关的其他围产期并发症。
在双胞胎分析中，较大和较小婴儿之间的 ROP 无显著差异，而对个体婴儿的分析显示，出生体重较小与 ROP 结局之间存在强烈关联。然而，在较大和较小婴儿组中，<28 周的胎龄与 ROP 结局显著相关。两组双胞胎之间在其他围产期并发症（如支气管肺发育不良、呼吸窘迫综合征、动脉导管未闭、颅内出血和脑室周围白质软化）方面无差异。
在双胞胎研究中，出生体重与 ROP 无关，而胎龄与 ROP 有关，这表明胎龄比出生体重更能预测 ROP。这表明成熟度在 ROP 的发病机制中比宫内生长更为重要。
