Department of Pediatrics, John H Stroger Hospital of Cook County, Chicago, Illinois, United States of America.
A. T. Still University School of Osteopathic Medicine, Arizona, United States of America.
PLoS One. 2020 Aug 3;15(8):e0236639. doi: 10.1371/journal.pone.0236639. eCollection 2020.
Retinopathy of prematurity (ROP) is a significant morbidity in preterm babies. Multiple risk factors for severe ROP have been extensively studied, however, only a few studies have included maternal diabetes mellitus (MDM) in their assessment. ROP and diabetic retinopathy are both retinal vascular diseases in which there is leakage and/or neovascularization from damaged retinal vessels. Diabetes may affect ROP development; however, there are conflicting results on the association between MDM and ROP.
To determine if MDM is an independent risk factor for clinically significant ROP (ROP > Stage II) in neonates weighing less than 1500g.
DESIGN/METHOD: We conducted a retrospective cohort study of neonates weighing <1500g who were delivered or transferred into our institution from 2007 through 2017. Logistic regression was used to analyze the association between severe ROP and MDM. The risks for the different stages of ROP from MDM were compared using chi-square linear trend test.
We extracted 883 paired maternal-neonatal data. The mean (standard deviation) gestational age and birthweight were 28.5 (2.9) weeks and 1052.7 (300.9) grams, respectively. Of the 883 mothers, 72 (8.2%) had DM. The incidence of ROP and severe ROP was 42.4% (374/883) and 6.5% (57/883) respectively. The odds ratio comparing MDM and severe ROP was 3.47 [95% CI: 1.51-7.96]; p<0.01). Compared to Stage I, the risk of MDM in infants with ROP increased from 1.49 in Stage II ROP to 2.59 in Stages III&IV. Severe ROP was associated with infant steroid use (OR: 5.92 [95% CI: 2.83-12.38]; p <0.01), sepsis (OR: 2.13 [95% CI: 1.09-4.14]; p = 0.03) chorioamnionitis (OR: 1.90 [95% CI: 1.03-3.50]; p = 0.04), and maternal steroid use (OR: 0.51 [95% CI: 0.32-0.79]; p<0.01).
Maternal diabetes is associated with ROP and the strength of association increased with increasing severity of ROP.
早产儿视网膜病变（ROP）是早产儿的一种重要的发病率。已经对多种严重 ROP 的危险因素进行了广泛研究，但是，只有少数研究将母亲糖尿病（MDM）纳入其评估范围。ROP 和糖尿病性视网膜病变都是视网膜血管疾病，其中受损的视网膜血管会发生渗漏和/或新生血管形成。糖尿病可能会影响 ROP 的发展，但是，MDM 与 ROP 之间的关联存在矛盾的结果。
确定母亲糖尿病是否是体重小于 1500g 的新生儿发生临床显著 ROP（ROP> II 期）的独立危险因素。
设计/方法：我们对 2007 年至 2017 年间在我们机构分娩或转入的体重小于 1500g 的新生儿进行了回顾性队列研究。使用逻辑回归分析严重 ROP 与 MDM 之间的关联。使用卡方线性趋势检验比较 MDM 与不同 ROP 阶段之间的风险。
我们提取了 883 对母婴数据。平均（标准差）胎龄和出生体重分别为 28.5（2.9）周和 1052.7（300.9）克。在 883 位母亲中，有 72 位（8.2％）患有糖尿病。ROP 和严重 ROP 的发生率分别为 42.4％（374/883）和 6.5％（57/883）。比较 MDM 和严重 ROP 的优势比为 3.47 [95％CI：1.51-7.96]；p<0.01）。与 I 期相比，ROP 婴儿中 MDM 的风险从 II 期 ROP 的 1.49 增加到 III 和 IV 期的 2.59。严重 ROP 与婴儿类固醇使用（OR：5.92 [95％CI：2.83-12.38]；p <0.01），败血症（OR：2.13 [95％CI：1.09-4.14]；p = 0.03）和绒毛膜羊膜炎（OR：1.90 [95％CI：1.03-3.50]；p = 0.04）以及母亲类固醇使用（OR：0.51 [95％CI：0.32-0.79]；p<0.01）相关。
母亲糖尿病与 ROP 相关，其与 ROP 严重程度的关联强度随着 ROP 严重程度的增加而增加。
