Clinical analysis of the relationship between retinopathy of prematurity and bronchopulmonary dysplasia_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Lili ^1,2 , Li Rui ^1,2 , Zeng Yueyao ^1,2 ,  Liu Dongyun ¹

1. Department of Pediatrics, Affiliated Hospital of Qingdao University, Qingdao 266003, China;
2. Clinical Medical College of Qingdao University Medical College, Qingdao 266071, China;

Corresponding author：

Liu Dongyun, Email: liudongyun007@163.com

Keywords：

Retinopathy of prematurity/etiology; Bronchopulmonary dysplasia; Risk factors

DOI：

10.3760/cma.j.cn511434-20200424-00174

Video：

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Objective To investigate the clinical risk factors of preterm infants and its severity in premature infants with bronchopulmonary dysplasia (BPD) with retinopathy of prematurity (ROP).Methods Retrospective clinical study was performed. A total of 126 preterm infants with BPD in the Neonatal Department of the Affiliated Hospital of Qingdao University from January 2016 to December 2018 were enrolled in the study. Among them, 69 were males and 57 were females, whose gestational age＜32 weeks and birth weight＜1500 g. BPD grades Ⅰ, Ⅱ, and Ⅲ were 63, 40, and 23 cases respectively. According to the presence or absence of ROP, children were divided into ROP group and non-ROP group, with 48 (38.1%) and 78 (61.9%) cases respectively. The differences of clinical data between the two groups were compared and analyzed. Quantitative data comparison between groups was performed by t test, and count data comparison was performed by χ² test. The risk factors of ROP in BPD premature infants were analyzed by multi-factor logistics regression. The correlation between BPD severity and ROP severity was tested by Spearman rank correlation test.Results Compared with the non-ROP group, the ROP group had a smaller gestational age (t=5.988), lower birth weight (t=7.371), higher the application rate of oxygen concentration＞30% (duration of service＞24 h), high rate (χ²=17.244) and longer noninvasive ventilation time (t=－7.139), the differences were statistically significant (P＜0.05). In the logistic regression model, the noninvasive ventilation time was the risk factor for ROP in preterm infants with BPD (OR≈1.054, P＜0.05), while gestational age and birth weight were importantly protective factors for ROP in preterm infants with BPD (OR≈0.938, 0.996; P＜0.05). The results of the correlation analysis found that the severity of BPD was significantly positively correlated with the severity of ROP. As the severity of BPD increased, the severity of ROP increased, and the difference was statistically significant (r_s=0.306, P＜0.035).Conclusions Fetal gestational age, low birth weight, hyperoxia, and long-term non-invasive mechanical ventilation are the main risk factors for ROP in preterm infants with BPD. The severity of BPD is positively correlated with the incidence and severity of ROP.

Citation： Li Lili, Li Rui, Zeng Yueyao, Liu Dongyun. Clinical analysis of the relationship between retinopathy of prematurity and bronchopulmonary dysplasia. Chinese Journal of Ocular Fundus Diseases, 2020, 36(8): 600-604. doi: 10.3760/cma.j.cn511434-20200424-00174 Copy

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1. Piersigilli F, Bhandari V. Metabolomics of bronchopulmonary dysplasia[J]. Clin Chim Acta, 2020, 500: 109-114. DOI: 10.1016/j.cca.2019.09.025.
2. Solans Pérez de Larraya AM, Ortega Molina JM, Uberos Fernández J, et al. Speed of retinal vascularization in retinopathy of prematurity: risk and protective factors[J/OL]. Biomed Res Int, 2019, 2019: 2721578[2019-04-24]. https://doi.org/10.1155/2019/2721578. DOI: 10.1155/2019/2721578.
3. Higgins RD. Oxygen saturation and retinopathy of prematurity[J]. Clin Perinatol, 2019, 46(3): 593-599. DOI: 10.1016/j.clp.2019.05.008.
4. Thébaud B, Goss KN, Laughon M, et al. Bronchopulmonary dysplasia[J]. Nat Rev Dis Primers, 2019, 5(1): 78. DOI: 10.1038/s41572-019-0127-7.
5. Chang JW. Risk factor analysis for the development and progression of retinopathy of prematurity[J/OL]. PLoS One, 2019, 14(7): 0219934[2019-07-18]. https://doi.org/10.1371/journal.pone.0219934. DOI: 10.1371/journal.pone.0219934.
6. Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop[J]. J Pediatr, 2018, 197: 300-308. DOI: 10.1016/j.jpeds.2018.01.043.
7. 中国医师协会新生儿科医师分会. 早产儿治疗用氧和视网膜病变防治指南(修订版)[J]. 发育医学电子杂志, 2016, 4(4): 196-198. DOI: 10.3969/j.issn.2095-5340.2016.04.003.Chinese Neonatologist Association. Guidelines for the treatment of premature infants with oxygen and the prevention and treatment of retinopathy (revised edition)[J]. Journal of Developmental Medicine (Electronic Version), 2016, 4(4): 196-198. DOI: 10.3969/j.issn.2095-5340.2016.04.003.
8. International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999. DOI: 10.1001/archopht.123.7.991.
9. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial[J]. Arch Ophthalmol, 2003, 121(12): 1684-1694. DOI: 10.1001/archopht.121.12.1684.
10. Singh JK, Wymore EM, Wagner BD, et al. Relationship between severe bronchopulmonary dysplasia and severe retinopathy of prematurity in premature newborns[J]. J AAPOS, 2019, 23(4): 201-209. DOI: 10.1016/j.jaapos.2019.02.008.
11. Podraza W, Michalczuk B, Jezierska K, et al. Correlation of retinopathy of prematurity with bronchopulmonary dysplasia[J]. Open Med (Wars), 2018, 13: 67-73. DOI: 10.1515/med-2018-0012.
12. O'Reilly M, Sozo F, Harding R. Impact of preterm birth and bronchopulmonary dysplasia on the developing lung: long-term consequences for respiratory health[J]. Clin Exp Pharmacol Physiol, 2013, 40(11): 765-773. DOI: 10.1111/1440-1681.12068.
13. Palmer EA, Flynn JT, Hardy RJ, et al. Incidence and early course of retinopathy of prematurity[J]. Ophthalmology, 2020, 127(4S): S84-96. DOI: 10.1016/j.ophtha.2020.01.034.
14. Siffel C, Kistler KD, Lewis JFM, et al. Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review[J/OL]. J Matern Fetal Neonatal Med, 2019, 2019: E1[2019-08-09]. https://doi.org/10.1080/14767058.2019.1646240. DOI: 10.1080/14767058.2019.1646240. [publishedonline ahead of print].
15. Taner A, Tekle S, Hothorn T, et al. Higher incidence of retinopathy of prematurity in extremely preterm infants associated with improved survival rates[J/OL]. Acta Paediatr, 2020, 2020: E1[2020-01-28]. https://doi.org/10.1111/apa.15197.DOI: 10.1111/apa.15197.[publishedonline ahead of print].
16. Abu-Shaweesh JM, Khasawneh W, Tang AS, et al. Compared to cpap extubation to non-invasive ventilation is associated with higher risk of bronchopulmonary dysplasia in extremely low birth weight infants[J]. J Neonatal Perinatal Med, 2020, 13(2): 183-188. DOI: 10.3233/NPM-190354.
17. Pastro J, Toso BRGO. Influence of oxygen in the development of retinopathy of prematurity[J]. Rev Bras Enferm, 2019, 72(3): 592-599. DOI: 10.1590/0034-7167-2018-0361.
18. Banjac L, Banjac G, Kotur-Stevuljević J, et al. Pro-oxidants and antioxidants in retinopathy of prematurity[J]. Acta Clin Croat, 2018, 57(3): 458-463. DOI: 10.20471/acc.2018.57.03.08.
19. Askie LM, Darlow BA, Finer N, et al. Association between oxygen saturation targeting and death or disability in extremely preterm infants in the neonatal oxygenation prospective meta-analysis collaboration[J]. JAMA, 2018, 319(21): 2190-2201. DOI: 10.1001/jama.2018.5725.
20. Manja V, Saugstad OD, Lakshminrusimha S. Oxygen saturation targets in preterm infants and outcomes at 18-24 months: a systematic review[J/OL]. Pediatrics, 2017, 139(1): 20161609[2017- 01-01]. https://doi.org/10.1542/peds.2016-1609. DOI: 10.1542/peds.2016-1609.
21. Raghuveer TS, Zackula R. Strategies to prevent severe retinopathy of prematurity: a 2020 update and meta-analysis[J]. Neoreviews, 2020, 21(4): 249-263. DOI: 10.1542/neo.21-4-e249.

Chinese Journal of Ocular Fundus Diseases

Clinical analysis of the relationship between retinopathy of prematurity and bronchopulmonary dysplasia

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