Neonatal Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health, Sciences Center, Oklahoma City, Oklahoma, USA.
Department of Ophthalmology and Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Ophthalmic Epidemiol. 2023 Feb;30(1):95-102. doi: 10.1080/09286586.2022.2036766. Epub 2022 Feb 9.
To determine the associations of presence and types of cardiovascular diseases (CVDs) with development of retinopathy of prematurity (ROP) in premature infants undergoing ROP examinations.
We performed secondary analyses of data from the multi-center Postnatal Growth and ROP Validation Study (GROP-2). CVD was categorized based on pulmonary blood flow (PBF), systemic blood flow (SBF), pulmonary hypertension (PPHN), or dysrhythmia. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were calculated from multivariable logistic regression models that included any ROP or severe ROP as outcome variable and any CVD or type of CVD as independent variable, with adjustment of covariates including birth weight (BW), gestational age (GA), and days on supplemental oxygen in the first month of postnatal life.
Among 3980 infants, 528 (13.3%) had CVD (304 had increased PBF, 101 had decreased PBF, and 49 had PPHN), 1643 (40.4%) developed ROP, and 503 (12.6%) developed severe ROP. In multivariable analyses, presence of CVD was not significantly associated with increased risk of any ROP (aOR = 1.15, 95% CI: 0.90-1.46, = .26) or severe ROP (aOR = 0.98, 95% CI: 0.72-1.34, = .92). However, there were trends associating CVD resulting in increased PBF with a higher risk of ROP (aOR = 1.32, 95% CI: 0.97-1.80, = .08) and PPHN with a higher risk of severe ROP (aOR = 2.04, 95% CI: 0.96-4.35, = .07). When adjusting only for BW and GA, these associations were significant (aOR = 1.47, 95% CI: 1.09-1.99, and aOR = 2.35, 95% CI: 1.19-4.65, respectively).
CVD with increased PBF likely increases the risk of ROP. PPHN likely increases the risk of severe ROP.
确定心血管疾病 (CVD) 的存在和类型与接受早产儿视网膜病变 (ROP) 检查的早产儿 ROP 发展之间的关联。
我们对多中心出生后生长和 ROP 验证研究 (GROP-2) 的数据进行了二次分析。CVD 根据肺血流量 (PBF)、体循环血流量 (SBF)、肺动脉高压 (PPHN) 或心律失常进行分类。从多变量逻辑回归模型中计算调整后的优势比 (aOR) 和 95%置信区间 (95%CI)，该模型将任何 ROP 或严重 ROP 作为结局变量，任何 CVD 或 CVD 类型作为自变量，调整了包括出生体重 (BW)、胎龄 (GA) 和出生后第一个月补充氧气天数在内的协变量。
在 3980 名婴儿中，528 名 (13.3%) 患有 CVD(304 名 PBF 增加，101 名 PBF 减少，49 名 PPHN)，1643 名 (40.4%) 发生 ROP，503 名 (12.6%) 发生严重 ROP。在多变量分析中，CVD 的存在与任何 ROP 的风险增加无关（aOR=1.15，95%CI：0.90-1.46，p=0.26）或严重 ROP（aOR=0.98，95%CI：0.72-1.34，p=0.92）。然而，存在一些趋势表明，导致 PBF 增加的 CVD 与 ROP 风险增加相关（aOR=1.32，95%CI：0.97-1.80，p=0.08），PPHN 与严重 ROP 风险增加相关（aOR=2.04，95%CI：0.96-4.35，p=0.07）。当仅调整 BW 和 GA 时，这些关联具有统计学意义（aOR=1.47，95%CI：1.09-1.99，aOR=2.35，95%CI：1.19-4.65）。
PBF 增加的 CVD 可能会增加 ROP 的风险。PPHN 可能会增加严重 ROP 的风险。
