Role of fetal hemoglobin in the development and progression of retinopathy of prematurity in preterm infants.

PURPOSE

The objective of this study was to find the association between fetal hemoglobin (HbF) concentration and retinopathy of prematurity (ROP) in preterm infants.

METHODS

In this observational, prospective, longitudinal study, a total of 410 preterm infants with <36 gestational weeks and <2.5 kg birth weight, who were attending ROP clinic in a tertiary care hospital of central India for 1 year duration were included. Dilated fundus examination was done as per ROP screening guidelines, and ROP was staged as per international classification for retinopathy of prematurity (ICROP) classification, 2021. HbF (%) was measured with high-performance liquid chromatography, and data was analyzed statistically. The relationship between HbF (%) and ROP was evaluated. Those infants who had ROP were further divided into treatment-requiring and non-treatment-requiring groups and HbF was compared in these groups at the first visit and after 1-month follow-up period. The outcome of ROP was studied with HbF levels.

RESULTS

A total of 410 preterm infants were included, out of which 110 infants had ROP (26.8%). Infants with ROP had significantly lower percentage of HbF with gestational age groups and birth weight groups, compared to infants without ROP. Higher percentage of HbF was associated with a lower prevalence of ROP. Higher concentration of HbF was found in the ROP infants who regressed spontaneously without treatment and less concentration was found in those who progressed to a severe disease and those who required treatment. The predictive ability of HbF (%) was 0.976 for ROP.

CONCLUSION

Low fraction of HbF was found to be significantly associated with the development and progression of ROP.