HYPERGLYCEMIAAS AN INDEPENDENT RISK FACTOR FOR RETINOPATHY OF PREMATURITY (ROP): A COHORT STUDY

Abstract

OBJECTIVE: Retinopathy of prematurity (ROP) is a severe morbidity that can lead to blindness in premature babies. Neonatal hyperglycemia\nhas been related to the growth of ROP in a variety of studies. However, there aren t many observational trials to show whether hyperglycemia is\nlinked to ROP in the absence of other comorbidities. The aim of this research was to see if hyperglycemia in premature babies is linked to ROP in a\ndifferent way.\nSTUDY DESIGN: Premature infants (<1500 g or⩽ 32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All\ndemographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 hours daily for \uf001rst 7\n,\ndays of live. For any glucose reading <50 or>150 mg dl 1 serum sample was sent to the laboratory for con\uf001rmation. Hyperglycemia was de\uf001ned as\nany blood glucose level⩾ 150 mg dl\n− 1. ROP patients were compared with non-ROP patients in a bivariate analysis. Variables signi\uf001cantly associated with ROP were studied in a\nlogistic regression model.\nRESULT:Atotal of 100 patients were enrolled with gestational age <32weeks and birth weight\n<1500g. Forty-eight patients (48%) were identi\uf001ed with hyperglycemia. On eye examination, 30 cases (30%) had ROP (19 with stage 1, 10 with\nstage 2 and 1 with stage 3). There were more cases of ROPin the hyperglycemia group compared with the euglycemia group (45.83% vs 15.38%, P\n= 0.007). Patients who developed ROP had signi\uf001cantly higher maximum and average glucose concentrations when compared with non-ROP\npatients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support\nand poor weight gain. However, in a logistic regression model including all signi\uf001cant variables, average blood glucose in the \uf001rst week of life was\nthe factor independently associated with ROPwith an odds ratio of: 1.77 (95% con\uf001dence interval: 1.08 to 2.86), P= 0.024\nCONCLUSION: In a prospective cohort study of premature infants, elevated average blood glucose concentrations in the \uf001rst week of life is an\nindependent risk factor associated with the development of ROP.