BACKGROUND:

Retinopathy of Prematurity (ROP) is the  main cause of childhood blindness in Argentina. Recent stu dies suggest than postnatal growth and related factor s as  ILGF levels can play an important role in the develop ment of retinopathy of prematurity (ROP). 

OBJECTIVE:

To evaluate clinical and nutritional factors  associated with the development of ROP (any stage) an d severe ROP (stage III and IV). 

DESIGN/METHODS:

Cohort study. Inclusion criteria: inb orn infants between 08/2003 to 11/2005 with gestation al age (GA) <32 weeks and birth weight (BW) <1500 g.  Clinical  conditions and daily growth in g/kg/day were recorded f rom BW recovery up to day 28. Statistical analysis: Two  predictive models of logistical regression were constru cted. 

RESULTS:

152 patients met the inclusion criteria, 8  were transferred and 3 died before day 28. Data fro m the remaining 141 patients were analyzed. Fifty fi ve patients  developed ROP (39%), they had less GA and BW: 28.3 w  vs. 29.6 w (p<0.001) and BW 1090 g vs.1190 g (p=0.0 07). Higher prevalence of late onset sepsis: 44% vs 22  %  (p=0.012); more days in oxygen: 55 vs 28 (p< 0.001),  more days in mechanical ventilation: 21 vs 10 (p= 0.02) , higher prevalence of bronchopulmonary dysplasia: 51% v s 31%  (p=0.02), higher caloric and protein deficit at day 2 8: -695 cal/k and -22 g/k vs. -466 g/k and -15 g/k ( p=0.003 and 0.004 respectively), and lower daily grow th: 16 g/k/d vs.  22g/k/d (p=0.038). Multivariate analysis showed that  for each week of lower GA the chances of any grade of R OP increased 60% (95% CI 55-81). Patients who had an  increase in body weight higher than 20 g/k/d had 58%  (95% CI 7-80) less chances of developìng ROP. Sixteen pa tients had a diagnosis of severe ROP (III and IV stage s) and  was associated to late onset sepsis (aOR 0.2, CI 95% 0.0 5-0.75), this model represents a negative predective va lue of 94%. Lower GA and less than 20 g/k/d of body  weight  in crease up to day 28 were associeted independently with R OP. ROP stages III and IV were associated with late onse t sepsis and lower GA. 

CONCLUSIONS:

GA and postnatal growth failure can be  associated independently with ROP development. The imp act of new nutritional interventions for decreasing p ostnatal  growth restriction should be evaluated. This study confi rms the relevance of GA as a major guide for ROP screen ing in our clinical setting. 

E-PAS20104420.495