Retinopathy Of Prematurity In Small-for-gestational-age Premature Infants

JULIO A. URRETS-ZAVALIA; ERNA G. KNOLL; MARIA E. FORNIES-PAZ; NICOLAS CRIM; PAULA B. LOPEZ-GIORDANO; RODOLFO MONTI; ELIZABETH COLLINO; HORACIO M. SERRA

Congreso; ARVO; 2011

Purpose: To evaluate the possible association between retinopathy of prematurity (ROP) and percentiles of birth: according-to-gestational-age (AGA), small-for-gestational-age (SGA), or large-for-gestational-age (LGA) premature infants (PI).Methods: 117 PI were evaluated prospectively in the Neonatology department of a 3rd level public hospital in Cordoba, Argentina, that were born at or with a referral of ≤24 h to our unit from May 2009 through November 2010, in order to evaluate ROP prevalence and severity. In each control, body weight and weight gain were recorded, and both eyes fully dilated and examined with binocular indirect ophthalmoscopy by experienced ophthalmologists in ROP screening. First exam was performed between the 2nd and the 4th week of life.Results: Infants were grouped according to birth weight (BW): ≤1000g (10 infants-8.5%), 1000-1500g (26-22.2%), 1500-2000g (32-27.3%), 2000-2500g (34-29%), ≥2500g (15-12.8%); according to gestational age (GA): ≤29 weeks (7 infants-5.9%), 29-32 weeks GA (33-28.2%) and 33-36 weeks (77-65.8%), and according to their percentiles they were classified in SGA (45patients-38.5%), AGA (69-59%), and LGA (3-2.5%). Mean weight gain (WG) was: SGA 19.8±6.2g/day (r=20.28 to 23.60); AGA 15.84 ± 9.56g/day (r= -10.65 to 41.66) and LGA 3.46 ± 1.09g/day (r=2.50 to 4.65). All types ROP were diagnosed in 11 (9.4%) patients; 10 infants (90.9%) were SGA, 1 (9.1%) AGA and none was LGA. In 5 infants (45.5%) had type 1 ROP; 4 of those infants (36.5%) were treated and 1 showed spontaneous involution. The principal related causes for SGA prematurity were uncontrolled gestation and maternal malnutrition.Conclusions: The prevalence of ROP was extremely high in SGA premature infants compared with PI that were in accordance with GA. Severe ROP was also higher in SGA PI compared with PI that were in accordance with GA. SGA prematurity should be considered an important risk factor for ROP blindness, and those infants should be monitored carefully.