Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants

• Published in: Journal of perinatology Vol. 31; no. 12; pp. 749 - 756
• Main Authors: Chavez-Valdez, R, McGowan, J, Cannon, E, Lehmann, C U
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.12.2011; Nature Publishing Group
• Subjects: 692/699; 692/700/1720; Babies; Birth weight; Blood Glucose - analysis; Development and progression; Female; Gestational age; Glucose; Glycemic index; Health aspects; Health sciences; Hospitals; Humans; Hyperglycemia; Hypoglycemia; Illnesses; Infant, Extremely Low Birth Weight; Infant, Newborn; Infant, Premature; Infants; Infants (Premature); Intensive care; Male; Management; Medicine; Medicine & Public Health; Neonatal care; Neonatal intensive care units; Neonates; original-article; Pediatric Surgery; Pediatrics; Physiology; Regression analysis; Retinopathy; Retinopathy of Prematurity - blood; Retinopathy of Prematurity - complications; Retinopathy of Prematurity - therapy; Retrolental fibroplasia; Risk factors; Sepsis; United States; United States > US; Texas; hyperglycemia; severity of illness; sepsis; hypoglycemia
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2011.19

Objective: The objective of this study is to investigate the relationship between glycemic status and severe retinopathy of prematurity (ROP). Study Design: This is a retrospective cohort study of 114 infants <1000 g admitted to a level IV neonatal intensive care unit within 48 h of life. A cumulative, time-weighted glucose level (TWGL) derived from plotting glucose values over time was included in logistic regression analysis to identify predictors for severe ROP. Result: Infants had 26.6±2 weeks gestational age and had a birth weight of 782±136 g. TWGL during first 10 and 30 days of life were greater in the severe ROP group ( P <0.01). Unlike single events of glucose levels ⩾150 mg dl −1 , 10 days TWGL ⩾100 mg dl −1 (odds ratio (OR) 5.2, P <0.02) and 30 days TWGL ⩾118 mg dl −1 (OR 5.7, P <0.02) were predictors for severe ROP (univariate). Multivariate regression confirmed 30 days TWGL ⩾118 mg dl −1 (OR 9.4 to 10) and gram-positive sepsis (OR 4.1 to 5) as predictors for severe ROP ( P <0.05). Conclusion: High overall glycemic status is associated with the development of severe ROP.