Christensen Robert D, Bahr Timothy M, Ilstrup Sarah J, Hartnett M Elizabeth, Ohls Robin K
Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Neonatology Research and Clinical Program, Intermountain Health, Murray, UT, USA.
J Perinatol. 2025 Jul 23. doi: 10.1038/s41372-025-02368-0.
Retinopathy of Prematurity (ROP) remains a worldwide problem. A more complete understanding of the pathogenesis might inform progress toward its elimination. ROP pathogenesis is undeniably complex, including preterm birth and oxygen exposure, but many other factors are implicated as well. In this Perspective, we focus on two pathogenic factors that are within the domain of neonatal hematology and transfusion medicine. Specifically, we address evidence that ROP pathogenesis can involve: 1) an elevated nucleated red blood cell (NRBC) count at preterm birth, as evidence of chronic hypoxia in utero, which should be recognized as a biomarker of elevated risk for developing ROP; and 2) transfusions of adult donor red blood cells (RBC) result in a dose-dependent elevation in adult hemoglobin (HbA), which can deliver and release excessive oxygen to the developing retina. Early studies indicate that eliminating adult donor RBC transfusions for vulnerable preterm infants might reduce or eliminate ROP.
早产儿视网膜病变（ROP）仍然是一个全球性问题。对其发病机制更全面的了解可能会推动消除该疾病的进展。ROP的发病机制无疑是复杂的，包括早产和氧暴露，但也涉及许多其他因素。在这篇观点文章中，我们关注新生儿血液学和输血医学领域内的两个致病因素。具体而言，我们探讨了以下证据：ROP发病机制可能涉及：1）早产时核红细胞（NRBC）计数升高，这是子宫内慢性缺氧的证据，应被视为发生ROP风险升高的生物标志物；2）输注成人供体红细胞（RBC）会导致成人血红蛋白（HbA）呈剂量依赖性升高，这会向发育中的视网膜输送和释放过多氧气。早期研究表明，消除对脆弱早产儿输注成人供体RBC可能会减少或消除ROP。
