Boskabadi Hassan, Shoeibi Naser, Bagheri Fatemeh, Pourbadakhshan Nafiseh, Moradi Ali, Zakerihamidi Maryam
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Ophthalmology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Curr Pediatr Rev. 2023;19(2):197-202. doi: 10.2174/1573396318666220819151154.
One of the most common problems in preterm neonates is retinopathy of prematurity (ROP). It has been shown antioxidants may be effective in preventing the development and progression of ROP. Considering the antioxidant properties of bilirubin, we decided to investigate the bilirubin level in neonates with ROP and compare it with healthy neonates.
This case-control study was performed on VLBW neonates admitted to the NICU of Ghaem Hospital in Mashhad between 2014 and 2020 for a Jaundice evaluation. Complete neonate's characteristics, maternal history and laboratory results were collected in a questionnaire. Then the neonates were examined for ROP by a fellowship of the retina of an ophthalmologist at 32 weeks or four weeks after birth. The highest bilirubin levels during their hospitalization were also recorded.
Of 427 neonates examined, 121 (37.7%) had a normal eye examination, and 266 (62.3%) had ROP. The mean weight, gestational age and bilirubin were 1455.8 ± 431.4 grams, 31.6 ± 2.3 weeks and 8.8 ± 2.4 mg/dl, respectively. There was a significant difference between controls and neonates with ROP with regard to birth weight, duration of intermittent positive pressure ventilation (IPPV), duration of oxygen therapy, first and fifth minute Apgar scores, the maximum level of bilirubin and gestational age (P < 0.05). It was observed that the maximum level of bilirubin was lower in neonates with higher stages of ROP.
According to the results of this study, higher levels of bilirubin in neonates may be a protective factor against ROP. Moreover, increased levels of bilirubin are associated with reduced severity of ROP. Therefore, prophylaxis phototherapy in premature infants may need to be reconsidered.
早产儿最常见的问题之一是早产儿视网膜病变（ROP）。研究表明，抗氧化剂可能对预防ROP的发生和发展有效。鉴于胆红素的抗氧化特性，我们决定研究ROP新生儿的胆红素水平，并与健康新生儿进行比较。
本病例对照研究对2014年至2020年间因黄疸评估入住马什哈德加姆医院新生儿重症监护病房的极低出生体重儿进行。通过问卷收集新生儿的完整特征、母亲病史和实验室检查结果。然后在出生后32周或4周由眼科医生的视网膜专科医生对新生儿进行ROP检查。同时记录他们住院期间的最高胆红素水平。
在检查的427例新生儿中，121例（37.7%）眼部检查正常，266例（62.3%）患有ROP。平均体重、胎龄和胆红素水平分别为1455.8±431.4克、31.6±2.3周和8.8±2.4毫克/分升。对照组与ROP新生儿在出生体重、间歇正压通气（IPPV）持续时间、氧疗持续时间、第一和第五分钟阿氏评分、最高胆红素水平和胎龄方面存在显著差异（P<0.05）。观察到ROP分期较高的新生儿胆红素最高水平较低。
根据本研究结果，新生儿较高水平的胆红素可能是预防ROP的保护因素。此外，胆红素水平升高与ROP严重程度降低有关。因此，可能需要重新考虑对早产儿预防性光疗的问题。
