Risk Factors for Retrolental Fibroplasia: Experience with 3,025 Premature Infants

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 339-344
Author(s):  
Dilip M. Purohit ◽  
R. Curtis Ellison ◽  
Sally Zierler ◽  
Olli S. Miettinen ◽  
Alexander S. Nadas
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Ductus Arteriosus ◽  
Maternal Diabetes ◽  
Oxygen Supplementation ◽  
Main Interest ◽  
Retrolental Fibroplasia

The rate of retrolental fibroplasia in relation to prenatal and neonatal characteristics was explored on the basis of a cohort of 3,025 neonates with birth weight less than 1,750 g. The overall rate of retrolental fibroplasia of any degree at hospital discharge was 11%, varying from 43% for those with birth weight between 500 and 749 g to 3% for those in the 1,500- to 1,750-g category. Among the potential determinants, the main interest was in nonhyperoxic characteristics, conditional on measures of prematurity and oxygen supplementation. Maternal diabetes and antihistamine use during the last 2 weeks of pregnancy were associated with significantly higher rates of retrolental fibroplasia, whereas toxemia was associated with lower rates. Frequent apneic spells, bronchopulmonary dysplasia, and sepsis in the neonate were also associated with significantly higher rates. On the other hand, the data indicate no independent role of low Apgar score, intraventricular hemorrhage, exchange transfusion, patent ductus arteriosus, or certain other characteristics previously postulated as risk factors.

scholarly journals SAFETY AND QUALITY OF INTRAVENOUS LIPIDS FOR NEWBORNS: EFFECTS ON CRITICAL DISEASES AND METABOLIC DISORDERS (PART II)

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 68-74
Author(s):  
I. Anikin ◽  
V. Snisar
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Metabolic Disorders ◽  
Ductus Arteriosus ◽  
Lipid Emulsions ◽  
Intravenous Lipids ◽  
Patent Ductus

Premature birth and its complications cause stress in newborns, which restrains their physical growth for several weeks after birth and is associated with chronic morbidity and neurological disability in the future. Preterm infants face such difficulties as respiratory distress, cardiovascular disease, gastrointestinal dysfunction and very low birth weight. Most complications in newborns are associated with oxidative stress that develops during the early period of growth. The formation of free radicals entails oxidative damage to many organs and systems of the body and is the main factor responsible for the development of typical diseases of preterm infants, such as bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, and respiratory distress syndrome. Premature infants depend on adequate early parenteral nutrition, which not only guarantees they will survive but also ensures positive health outcomes later in life. Early use of intravenous lipids helps to prevent essential fatty acid deficiencies, provides energy and substrates for cell membrane synthesis, which are important for the growth and development of infants with very low and extremely low birth weight. This publication represents data on the effect of intravenous lipids on critical conditions and metabolic disorders in newborns. Literature sources are analyzed and the existing evidence of the possible influence of lipid emulsions on critical diseases in newborns is presented: intraventricular hemorrhage; necrotizing enterocolitis, patent ductus arteriosus and thrombocytopenia; glucose metabolism (hypo- and hyperglycemia); hyperbilirubinemia and chronic liver damage. The literature review is aimed at finding optimal strategies for the use of lipid emulsions in intensive care of newborns to improve the quality of care for premature infants. The purpose of this work is to analyze the results of published studies and systematize data on the feasibility and safety of lipid emulsions used in newborns with critical diseases of the perinatal period.

scholarly journals Neonatal risk factors for respiratory morbidity during the first year of life among premature infants

2006 ◽  
Vol 124 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Rosane Reis de Mello ◽  
Maria Virgínia Peixoto Dutra ◽  
José Roberto Ramos ◽  
Pedro Daltro ◽  
Márcia Boechat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Lung Compliance ◽  
Respiratory Morbidity ◽  
Pulmonary Mechanics ◽  
First Year ◽  
First Year Of Life

CONTEXT AND OBJECTIVE: There have been dramatic increases in very low birth weight infant survival. However, respiratory morbidity remains problematic. The aim here was to verify associations between pulmonary mechanics, pulmonary structural abnormalities and respiratory morbidity during the first year of life. DESIGN AND SETTING: Prospective cohort study at Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro. METHODS: Premature infants with birth weight < 1500 g were studied. Lung function tests and high-resolution chest tomography were performed before discharge. During the first year, infants were assessed for respiratory morbidity (obstructive airways, pneumonia or hospitalization). Neonatal lung tests and chest tomography and covariables potentially associated with respiratory morbidity were independently assessed using relative risk (RR). RR was subsequently adjusted via logistic regression. RESULTS: Ninety-seven newborn infants (mean birth weight: 1113g; mean gestational age: 28 weeks) were assessed. Lung compliance and lung resistance were abnormal in 40% and 59%. Tomography abnormalities were found in 72%; respiratory morbidity in 53%. Bivariate analysis showed respiratory morbidity associated with: mechanical ventilation, prolonged oxygen use (beyond 28 days), oxygen use at 36 weeks, respiratory distress syndrome, neonatal pneumonia and patent ductus arteriosus. Multivariate analysis gave RR 2.7 (confidence interval: 0.7-10.0) for simultaneous lung compliance and chest tomography abnormalities. Adjusted RR for neonatal pneumonia and mechanical ventilation were greater. CONCLUSIONS: Upon discharge, there were high rates of lung mechanism and tomography abnormalities. More than 50% presented respiratory morbidity during the first year. Neonatal pneumonia and mechanical ventilation use were statistically significant risk factors.

scholarly journals The Severity of Retinopathy in the Extremely Premature Infants

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alexandra Trivli ◽  
Maria Polychronaki ◽  
Charoula Matalliotaki ◽  
Michail Papadimas ◽  
Athina E. Patelarou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Premature Infants ◽  
Nursing Staff ◽  
Gestational Age ◽  
Premature Births ◽  
Oxygen Supplementation ◽  
Advanced Stages ◽  
Group 2 ◽  
Group 1

Objective. We aimed to investigate the incidence and the severity of retinopathy of extremely premature infants and to evaluate the risk factors and outcome of the cases. Materials and Methods. Out of 200 premature births, we retrospectively reviewed 9 cases that developed ROP. We excluded cases where ROP developed in newborns > 30 weeks of gestational age and cases where medical notes were unavailable or incomplete. Topical drops of cyclopentolate 1% and phenylephrine 5% were instilled and fundoscopy was performed using a direct ophthalmoscope. Results. The incidence of ROP was 4.5% in the 9-year period. The infants were divided into two groups. Group 1 included premature infants ≤27 weeks of age and Group 2 included those >27 weeks but ≤ 30 weeks of age. We found that the infants of Group 1 showed advanced stages of ROP in comparison to Group 2. Out of 18 eyes, 11 eyes had stage 3 ROP and they were all found in Group 1 (100% of cases). Conclusion. The severity of ROP was associated with earlier gestational age, lower birth weight, and oxygen supplementation. Constant cooperation between physicians and nursing staff is necessary to avoid undetected cases and further prevent ROP related blindness.

Prophylactic Indomethacin for Prevention of Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 533-542
Author(s):  
Emmalee Setzer Bandstra ◽  
Berta M. Montalvo ◽  
Ronald N. Goldberg ◽  
Irma Pacheco ◽  
Pedro L. Ferrer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Prophylactic Use ◽  
Clinically Significant ◽  
The Impact ◽  
Patent Ductus

The impact of early prophylactic use of intravenous indomethacin on the incidence and severity of periventricular-intraventricular hemorrhage and patent ductus arteriosus in 199 oxygen-requiring premature infants (≤1300 g birth weight) was prospectively investigated. The trial was controlled, the infants were randomized, and the investigators were unaware of the group assignments. Patients with minimal (grade I) or no periventricular-intraventricular hemorrhage determined by prestudy echoencephalography were randomized within two birth weight subgroups (500 to 899 and 900 to 1300 g) to receive either prophylactic indomethacin (n = 99) or an equal volume of saline-vehicle placebo (n = 100). The first dose (0.2 mg/kg) was given within 12 hours of delivery and two subsequent doses (0.1 mg/kg) were administered at 12 hourly intervals. Prophylactic indomethacin significantly reduced the incidence of grades II to IV periventricular-intraventricular hemorrhage. Intraventricular hemorrhage was half as common in infants given prophylactic indomethacin as in control infants (23% v 46%, P &lt; .002). The reduction was manifested in both birth weight subgroups. Results of this study also confirmed a lower incidence of clinically significant patent ductus arteriosus in infants who received prophylactic indomethacin in contrast to those who received placebo (11% v 42%, P &lt; .001). No significant differences were found between treatment and control groups in the duration of oxygen therapy, mechanical ventilation, or hospitalization or in the incidence of pneumothorax, chronic lung disease, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Early prophylactic indomethacin initiated within 12 hours of delivery is effective in reducing the incidence of intraventricular hemorrhage as well as clinically significant patent ductus arteriosus in very low birth weight premature infants.

Effect of Prophylactic Phenobarbital on Intraventricular Hemorrhage in High-Risk Infants

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 435-439
Author(s):  
Mary P. Bedard ◽  
Seetha Shankaran ◽  
Thomas L. Slovis ◽  
Alfonso Pantoja ◽  
Bimleshwar Dayal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
High Risk ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Treated Group ◽  
Control Group ◽  
Treatment Groups ◽  
Potential Risk Factors ◽  
High Risk Infants

Forty-two premature infants less than 24 hours of age, with normal admission echoencephalograms, were randomly assigned to control or phenobarbital treatment groups. Infants in the treated group received two loading doses of 10 mg/kg of phenobarbital 12 hours apart, followed by a maintenance dose of 2.5 mg/kg every 12 hours for 6 days. Serial echoencephalograms were obtained in both groups. The groups were comparable with regard to birth weight, gestational age, and potential risk factors for subependymal-intraventricular hemorrhage. Ten infants (48%) in each group developed hemorrhage. The hemorrhages in the phenobarbital-treated group were significantly less severe than those in the control group. The phenobarbital-treated infants who bled, however, were also significantly larger and more mature than control infants who bled. The results of this study indicate no effect of phenobarbital on the incidence of subependymal-intraventricular hemorrhage, but a possible beneficial effect on the severity of hemorrhage.

RISK FACTORS FOR CARDIOVASCULAR DISEASE IN CHILDHOOD:THE ROLE OF BIRTH WEIGHT AND CURRENT OBESITY

2011 ◽  
Vol 29 ◽  
pp. e441
Author(s):  
C. Ponzio ◽  
R. Sesso ◽  
M. W. Strufaldi ◽  
M. Franco
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Birth Weight

Blood Pressure and Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1006-1007
Author(s):  
EDWARD H. PERRY ◽  
HENRIETTA S. BADA ◽  
JOHN D. DAY ◽  
SHELDON B. KORONES ◽  
KRISTOPHER L. ARHEART ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Stability Boundary ◽  
Mean Blood Pressure ◽  
Pressure Increase ◽  
Blood Pressure Increase ◽  
The Mean

In Reply.— We appreciate the interest and comments of Drs Puccio and Soliani regarding our article "Blood Pressure Increase, Birth Weight Dependent Stability Boundary and Intraventricular Hemorrhage."1 In response, we address the following points: 1. Although mean blood pressure (BP) values greater than 100 mm Hg were observed in some of our patients, these were quite rare. The mean BP was found to be less than 60 mm Hg 99% of the time. Thus, unless one is recording BPs through long periods and sampling quite often, the brief spikes likely would not be observed.

The Discovery of Retrolental Fibroplasia and the Role of Oxygen: A Historical Review, 1942–1956

2004 ◽  
Vol 23 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Elizabeth Reedy
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Historical Review ◽  
Retrolental Fibroplasia ◽  
History Of ◽  
To Come ◽  
The 1960S ◽  
Prematurely Born Infants ◽  
The U.S

Nearly 50 years after it was thought to be conquered, retinopathy of prematurity (ROP) continues to cause vision disturbances and blindness among prematurely born infants. During the 1940s and early 1950s, researchers and caregivers first identified and struggled to eliminate this problem, which seemed to come from nowhere and was concentrated among the most advanced premature nurseries in the U.S. Research studies initially identified many potential causes, none of which could be proved conclusively. By the mid-1950s, oxygen was identified as the culprit, and its use was immediately restricted. The rate of blindness among premature infants decreased significantly. ROP was not cured, however. By the 1960s, it had reappeared. The history of ROP serves to remind us that, despite our best intentions, the care and treatment of premature newborns will always carry with it the possibility of iatrogenic disease. This caution is worth remembering as we work to expand the quality and quantity of clinical research.

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