Dataset Information

Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity.

ABSTRACT:

Objective

To identify nutritional and weight gain limitations associated with retinopathy of prematurity (ROP) severity among very preterm newborns.

Patients and methods

1180 infants <28 weeks GA at birth with ROP examination results were grouped and analyzed by quartile of weekly total calorie, carbohydrate, protein, and lipid intake, as well as growth velocity between postnatal days 7 and 28 (adjusted for GA and birth weight Z-score). ROP was categorized by development of no, mild (ResultsGreater risk for Type 1 ROP (risk/95% confidence intervals) was found for infants with lowest quartile receipt of lipids (2.1/1.1, 3.8), total calories (2.2/1.4, 3.6), and carbohydrates (1.7/1.1, 2.9). Development of zone 1 ROP was associated with lipid or total calorie intake in the lowest quartile, and development of stage 3 ROP was associated with lowest quartile of total calorie intake. Growth velocity in the lowest quartile was associated with increased risk of any ROP, including type 1 ROP.

Conclusion

The risk of developing severe ROP in extremely premature infants might be reduced by improving nutritional support, specifically targeting lipids and total calories, and perhaps by improving weight gain.

SUBMITTER: VanderVeen DK

PROVIDER: S-EPMC3667175 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity.

VanderVeen Deborah K DK Martin Camilia R CR Mehendale Reshma R Allred Elizabeth N EN Dammann Olaf O Leviton Alan A

PloS one 20130529 5

<h4>Objective</h4>To identify nutritional and weight gain limitations associated with retinopathy of prematurity (ROP) severity among very preterm newborns.<h4>Patients and methods</h4>1180 infants <28 weeks GA at birth with ROP examination results were grouped and analyzed by quartile of weekly total calorie, carbohydrate, protein, and lipid intake, as well as growth velocity between postnatal days 7 and 28 (adjusted for GA and birth weight Z-score). ROP was categorized by development of no, mi ...[more]

PMID: 23734194

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Project description:ImportanceEarly slow postnatal weight gain, a surrogate for low insulinlike growth factor 1 (IGF-1) levels, is predictive of retinopathy of prematurity (ROP). While low IGF-1 levels inhibit retinal vessel growth, a later rise theoretically activates vascular endothelial growth factor, causing neovascularization. Rate of rise of IGF-1 level is represented by weight gain acceleration (WGA) and may be used to evaluate risk of ROP.ObjectiveTo evaluate whether faster WGA during a later postnatal period is associated with a higher, rather than lower, risk of severe ROP.Design, setting, and participantsThis secondary analysis of data from the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study included 6835 infants undergoing ROP examinations from 29 hospitals in North America from January 2006 to June 2012. Data were analyzed from September to December 2016.Main outcomes and measuresEarly weight gain rate (WGR) during 29 to 33 weeks' postmenstrual age and late WGA during 34 to 38 weeks' postmenstrual age were determined using linear regression of daily weight measurements and changes in daily weight measurements, respectively. The primary outcome was the association of late WGA with severe ROP.ResultsOf the 6835 included infants, the mean (SD) birth weight was 1086 (357) g, and the mean (SD) gestational age was 27.9 (2.5) weeks. Risk of severe ROP increased with increasing late WGA up to about the 80th percentile of WGA. After adjusting for birth weight and gestational age, among infants in the lowest early WGR tertile, there was no association of late WGA with severe ROP, and among infants in the moderate and highest early WGR tertiles, the moderate WGA tertiles had the highest risk of ROP (moderate early WGR tertile: adjusted odds ratio, 1.38; 95% CI, 0.98-1.94; highest early WGR tertile: adjusted odds ratio, 1.63; 95% CI, 1.02-2.60).Conclusions and relevanceAlthough much attention has been paid to the association of slow weight gain with ROP, the association may be more complex than appreciated. These findings suggest that low early WGR is associated with severe ROP regardless of subsequent WGA, but if early WGR is moderate or high, subsequent rapid rises in WGR are associated with increasing risk of severe ROP. If validated in additional cohorts, this finding may affect potential therapies, such as the timing of IGF-1 supplementation.

Dataset Information

Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity.

Objective

Patients and methods

Conclusion

Publications

Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity.

Similar Datasets

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