Slidsborg Carina, Jensen Louise Bering, Rasmussen Steen Christian, Fledelius Hans Callø, Greisen Gorm, Cour Morten de la
Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark.
Br J Ophthalmol. 2018 Jan;102(1):14-18. doi: 10.1136/bjophthalmol-2016-309187. Epub 2017 Jun 2.
To investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP).
This is a Danish national, retrospective, case-control study of premature infants (birth period 2003-2006). Three national registers were searched, and data were linked through a unique civil registration number. The study sample consisted of 106 cases each matched with two comparison infants. Matching criteria were gestational age (GA) at birth, ROP not registered and born at the same neonatal intensive care unit. Potential 'new' risk factors were analysed in a multivariate logistic regression model, while adjusted for previously recognised risk factors (ie, GA at birth, small for gestational age, multiple birth and male sex).
Hospital records of 310 preterm infants (106 treated; 204 comparison infants) were available. Nutrition in terms of energy (kcal/kg/week) and protein (g/kg/week) given to the preterm infants during the first postnatal week were statistically insignificant between the study groups (Mann-Whitney U test; p=0.165/p=0.163). Early postnatal weight gain between the two study groups was borderline significant (t-test; p=0.047). Hyperglycaemic events (indexed value) were statistically significantly different between the two study groups (Mann-Whitney U test; p<0.001). Hyperglycaemia was a statistically independent risk factor (OR: 1.022; 95% CI 1.002 to 1.042; p=0.031).
An independent association was found between the occurrence of hyperglycaemic events during the first postnatal week and later development of treatment-demanding ROP, when adjusted for known risk factors.
调查出生后第一周的新生儿高血糖是否与需要治疗的早产儿视网膜病变（ROP）相关。
这是一项针对丹麦全国2003 - 2006年出生的早产儿的回顾性病例对照研究。检索了三个国家登记册，并通过唯一的民事登记号码将数据关联起来。研究样本包括106例病例，每例病例与两名对照婴儿匹配。匹配标准为出生时的胎龄（GA）、未登记ROP且在同一新生儿重症监护病房出生。在多变量逻辑回归模型中分析潜在的“新”风险因素，同时对先前公认的风险因素（即出生时的GA、小于胎龄儿、多胎妊娠和男性）进行调整。
获得了310名早产儿（106例接受治疗；204例对照婴儿）的医院记录。在研究组之间，出生后第一周给予早产儿的能量（千卡/千克/周）和蛋白质（克/千克/周）方面的营养情况无统计学差异（曼 - 惠特尼U检验；p = 0.165/p = 0.163）。两个研究组之间出生后早期体重增加接近显著（t检验；p = 0.047）。两组之间高血糖事件（指数值）有统计学显著差异（曼 - 惠特尼U检验；p < 0.001）。高血糖是一个统计学上独立的风险因素（OR：1.022；95%CI 1.002至1.042；p = 0.031）。
在调整已知风险因素后，发现出生后第一周高血糖事件的发生与随后需要治疗的ROP的发展之间存在独立关联。
