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J AAPOS. 2014 Jun;18(3):241-7. doi: 10.1016/j.jaapos.2014.01.014.

Retinopathy of prematurity and brain damage in the very preterm newborn.

Author information

1
Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
2
William Beaumont Hospital, Royal Oak, Michigan.
3
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
4
Tufts University School of Medicine and Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts; Hannover Medical School, Hannover, Germany.
5
Helen DeVos Children's Hospital, Grand Rapids, Michigan.
6
Tufts University School of Medicine and Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts.
7
UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts.
8
Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
9
Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: alan.leviton@childrens.harvard.edu.
10
Wake Forest University School of Medicine, Winston-Salem, North Carolina.
11
College of Human Medicine, Michigan State University, East Lansing, Michigan.
12
Yale School of Medicine, New Haven, Connecticut.
13
Duke Eye Center, Durham, North Carolina.

Abstract

PURPOSE:

To explain why very preterm newborns who develop retinopathy of prematurity (ROP) appear to be at increased risk of abnormalities of both brain structure and function.

METHODS:

A total of 1,085 children born at <28 weeks' gestation had clinically indicated retinal examinations and had a developmental assessment at 2 years corrected age. Relationships between ROP categories and brain abnormalities were explored using logistic regression models with adjustment for potential confounders.

RESULTS:

The 173 children who had severe ROP, defined as prethreshold ROP (n = 146) or worse (n = 27) were somewhat more likely than their peers without ROP to have brain ultrasound lesions or cerebral palsy. They were approximately twice as likely to have very low Bayley Scales scores. After adjusting for risk factors common to both ROP and brain disorders, infants who developed severe ROP were at increased risk of low Bayley Scales only. Among children with prethreshold ROP, exposure to anesthesia was not associated with low Bayley Scales.

CONCLUSIONS:

Some but not all of the association of ROP with brain disorders can be explained by common risk factors. Most of the increased risks of very low Bayley Scales associated with ROP are probably not a consequence of exposure to anesthetic agents.

PMID:
24924276
PMCID:
PMC4057649
DOI:
10.1016/j.jaapos.2014.01.014
[Indexed for MEDLINE]
Free PMC Article

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