Gudu Rama K, Sahoo Swaranjika, Jena Pravati, Behura Sushree S, Priyadarshini Subhadra, Panda Santosh K
Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Research and Development, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2024 Jul 10;16(7):e64264. doi: 10.7759/cureus.64264. eCollection 2024 Jul.
Retinopathy of prematurity (ROP) is an important cause of visual morbidity among preterm infants. The objective of the study was to assess the relationship between the initial hematological parameters of the complete blood count (CBC) and ROP development in preterm neonates.
This retrospective cohort study was conducted in a neonatal intensive care unit in Odisha. The hematological parameters of the CBC conducted within the first 48 hours of age, demographic characteristics, neonatal morbidities, and ROP screening findings of preterm neonates (gestational age <34 weeks) were analyzed. Independent risk factors associated with ROP development were identified in a multivariate logistic regression model.
A total of 43 (29.1%) out of 148 neonates had any of the ROP stages (stage 1-26, 2-08, and 3-09). Birth weight (aOR 0.003; 95% CI 0.00, 0.11);hemoglobin (Hb) level (aOR 0.70; 95% CI 0.54, 0.90); presence of respiratory distress syndrome (RDS) (aOR 7.61; 95% CI 1.5, 36.39); and need for packed red blood cell (PRBC) transfusion (aOR 4.26; 95% CI 1.1, 16.44) were independently associated with ROP development. The odds of ROP were higher among the neonates with initial Hb 10.5-15.4 g/dL (OR (95% CI) 3.7(1.5, 8.9), p=0.003) and for neonates with Hb 15.4-17.3 g/dL (OR (95% CI) 2.5(1.01, 6.16), p=0.047) in comparison to neonates with initial Hb >17.3 g/dL.
Preterm neonates with a lower level of Hb during the early postnatal days are at higher risk for ROP development and need to be prioritized for screening.
早产儿视网膜病变（ROP）是早产儿视力受损的一个重要原因。本研究的目的是评估全血细胞计数（CBC）的初始血液学参数与早产儿ROP发生之间的关系。
本回顾性队列研究在奥里萨邦的一家新生儿重症监护病房进行。分析了早产儿（胎龄<34周）在出生后48小时内进行的CBC血液学参数、人口统计学特征、新生儿疾病及ROP筛查结果。在多因素逻辑回归模型中确定与ROP发生相关的独立危险因素。
148例新生儿中共有43例（29.1%）出现任何ROP阶段（1期-26例，2期-8例，3期-9例）。出生体重（调整后比值比[aOR]0.003；95%置信区间[CI]0.00，0.11）；血红蛋白（Hb）水平（aOR 0.70；95%CI 0.54，0.90）；呼吸窘迫综合征（RDS）的存在（aOR 7.61；95%CI 1.5，36.39）；以及需要输注浓缩红细胞（PRBC）（aOR 4.26；95%CI 1.1，16.44）与ROP发生独立相关。与初始Hb>17.3 g/dL的新生儿相比，初始Hb为10.5 - 15.4 g/dL的新生儿发生ROP的几率更高（比值比[OR（95%CI）]3.7（1.5，8.9），p = 0.003），初始Hb为15.4 - 17.3 g/dL的新生儿发生ROP的几率也更高（OR（95%CI）2.5（1.01，6.16），p = 0.047）。
出生后早期Hb水平较低的早产儿发生ROP的风险较高，需要优先进行筛查。
