Department of Pediatrics, Kaiser Permanente Los Angeles, California, United States of America.
Department of Ophthalmology, Kaiser Permanente Los Angeles, California, United States of America.
Early Hum Dev. 2021 Oct;161:105440. doi: 10.1016/j.earlhumdev.2021.105440. Epub 2021 Aug 8.
Retinopathy of prematurity (ROP) is a developmental retinal vaso-proliferative disease and a leading cause of blindness in children. Early gestational age, low birth weight and unregulated oxygen exposure are the main risk factors for the development of ROP. There are conflicting reports of a possible association between recombinant Erythropoietin (rhEPO) use and an increased risk for the development of ROP.
To determine whether rhEPO is an independent risk factor for the development of severe ROP among preterm infants with a gestational age of 23 to 32 weeks and a birth weight <1500 g.
We performed a retrospective study of risk factors for ROP on a cohort of 1762 premature infants born between 2009 and 2014, half of whom received rhEPO. To examine the association between treated ROP and rhEPO, a propensity score (PS) analysis was performed using the inverse probability of treatment weighted (IPTW) approach.
The incidence of treated ROP was 7.3% (129/1762). PS analysis did not show an association between rhEPO and severe ROP needing treatment or ROP stage 2 or higher, in either the whole population or in the subgroup of babies born at 23 to 28 weeks gestation, in whom the incidence of severe ROP was the highest. Of 117 patients treated for Type 1 or worsening stage 3 ROP, 17 were first diagnosed after NICU discharge.
Our study showed no association between Erythropoietin use and severe ROP and highlights the importance of Ophthalmology follow up after hospital discharge.
早产儿视网膜病变（ROP）是一种发育性视网膜血管增生性疾病，是儿童失明的主要原因。早产、低出生体重和未调节的氧暴露是 ROP 发展的主要危险因素。关于重组促红细胞生成素（rhEPO）的使用与 ROP 发展风险增加之间可能存在关联的报道存在矛盾。
确定 rhEPO 是否是 23 至 32 周胎龄和出生体重<1500g 的早产儿发生严重 ROP 的独立危险因素。
我们对 2009 年至 2014 年间出生的 1762 名早产儿进行了 ROP 危险因素的回顾性研究，其中一半接受了 rhEPO 治疗。为了研究治疗性 ROP 与 rhEPO 之间的关系，我们使用逆概率治疗加权（IPTW）方法进行了倾向评分（PS）分析。
治疗性 ROP 的发生率为 7.3%（129/1762）。PS 分析并未显示 rhEPO 与严重 ROP 治疗需要或 ROP 2 期及以上之间存在关联，无论是在全人群中还是在胎龄 23 至 28 周的婴儿亚组中，该亚组的严重 ROP 发生率最高。在 117 例因 1 型或加重 3 期 ROP 而接受治疗的患者中，有 17 例在 NICU 出院后首次确诊。
我们的研究表明，EPO 治疗与严重 ROP 之间无关联，并强调了眼科随访在出院后的重要性。
