Dataset Information

Cumulative evidence for association of sepsis and retinopathy of prematurity.

ABSTRACT:

Background

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease affected by multiple factors such as infection and preterm birth. The role of sepsis in the development of ROP remains controversial. This systematic review and meta-analysis aimed to identify the impact of sepsis on ROP.

Methods

The PubMed, Embase, and Cochrane Library databases were searched using terms related to sepsis and ROP. Cohort or case-control studies that reported the association of sepsis and ROP were eligible. The odds ratios (ORs) together with the 95% confidence interval (CI) were extracted from the studies or computed by authors if not provided.

Results

Thirty-four studies were ultimately included in this meta-analysis. The pooled results showed that sepsis increased the risk for the development of any stage ROP (OR?=?2.16; 95% CI: 1.65-2.82). Both early onset (OR?=?2.50; 95% CI: 1.97-3.18) and late-onset (OR?=?1.37; 95% CI: 1.22-1.55) sepsis were associated with severe ROP. Furthermore, both bacterial sepsis (OR?=?1.74; 95% CI: 1.21-2.50) and fungal sepsis (OR?=?2.96; 95% CI: 2.05-4.28) were also found to be associated with severe ROP.

Conclusion

Sepsis increased the risk of any stage ROP, especially for the severe ROP. Further high-quality clinical studies are needed to eliminate heterogeneity and publication bias to validate these findings.

SUBMITTER: Huang J

PROVIDER: S-EPMC6824763 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cumulative evidence for association of sepsis and retinopathy of prematurity.

Huang Jichong J Tang Ying Y Zhu Tingting T Li Yafei Y Chun Hua H Qu Yi Y Mu Dezhi D

Medicine 20191001 42

<h4>Background</h4>Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease affected by multiple factors such as infection and preterm birth. The role of sepsis in the development of ROP remains controversial. This systematic review and meta-analysis aimed to identify the impact of sepsis on ROP.<h4>Methods</h4>The PubMed, Embase, and Cochrane Library databases were searched using terms related to sepsis and ROP. Cohort or case-control studies that reported the association of seps ...[more]

PMID: 31626109

Similar Datasets

Project description:ImportancePrevious studies suggest that race or ethnicity may be associated with risk for developing retinopathy of prematurity (ROP). Little is known about how socioeconomic factors mediate the relationship between race or ethnicity and ROP outcomes.ObjectiveTo evaluate how socioeconomic factors, in the context of race and ethnicity, are associated with ROP outcomes.Design, setting, and participantsThis retrospective cohort study used US Census Bureau income data and electronic medical records from neonatal intensive care units at 4 hospitals, UCLA Mattel Children's Hospital, UCLA Santa Monica Hospital, Cedars-Sinai Medical Center, and Harbor-UCLA Medical Center. Eligible participants included neonates born at a gestational age (GA) of 30 weeks or less, birth weight less than 1500 g, or a GA at birth greater than 30 weeks but with an unstable clinical course. Participants were screened for ROP between January 1, 2010, and December 31, 2020.ExposuresRace and ethnicity data, GA, demographic and clinical information, proxy household income, and health insurance status were collected as risk factors.Main outcomes and measuresDiagnosis and severity of ROP were the main study outcomes. Severity was determined according to a classification system developed by the Early Treatment for Retinopathy of Prematurity Cooperative Group.ResultsIn a crude model, Hispanic neonates were more likely to be diagnosed with ROP (OR, 1.70; 95% CI, 1.20-2.42) and had more severe ROP (OR, 2.24; 95% CI, 1.21-4.15) compared with non-Hispanic White neonates; these associations were no longer found when adjusting for GA and socioeconomic factors (OR, 1.12; 95% CI, 0.68-1.82, and OR, 1.67; 95% CI, 0.80-3.52, for ROP diagnosis and severity, respectively). In a fully adjusted model, lower GA was the primary predictor of ROP incidence (OR, 0.52; 95% CI, 0.48-0.57; P < .001), and higher median household income was associated with higher GA (OR, 0.26; 95% CI, 0.09-0.43; P = .002).Conclusions and relevanceIn this cohort study, GA was the primary driver of disparities in ROP outcomes in a heterogeneous population of neonates in Los Angeles, California. When examined in the context of socioeconomic factors, GA did not differ between racial and ethnic groups. Studies of disparities associated with race and ethnicity should consider these constructs in conjunction with other sociodemographic factors and social determinants of health.

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

Cumulative evidence for association of sepsis and retinopathy of prematurity.

Background

Methods

Results

Conclusion

Publications

Cumulative evidence for association of sepsis and retinopathy of prematurity.

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