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Neumann RP, Gerull R, Hasler PW, Wellmann S, Schulzke SM. Vasoactive peptides as biomarkers for the prediction of retinopathy of prematurity. Pediatr Res 2024; 95:1868-1874. [PMID: 38402317 PMCID: PMC11245386 DOI: 10.1038/s41390-024-03091-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/27/2023] [Accepted: 01/28/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is a major complication in preterm infants. We assessed if plasma levels of midregional pro-atrial natriuretic peptide (MR-proANP) and C-terminal pro-endothelin-1 (CT-proET1) serve as early markers for subsequent ROP development in preterm infants <32 weeks gestation. METHODS Prospective, two-centre, observational cohort study. MR-proANP and CT-proET1 were measured on day seven of life. Associations with ROP ≥ stage II were investigated by univariable and multivariable logistic regression models. RESULTS We included 224 infants born at median (IQR) 29.6 (27.1-30.8) weeks gestation and birth weight of 1160 (860-1435) g. Nineteen patients developed ROP ≥ stage II. MR-proANP and CT-proET1 levels were higher in these infants (median (IQR) 864 (659-1564) pmol/L and 348 (300-382) pmol/L, respectively) compared to infants without ROP (median (IQR) 299 (210-502) pmol/L and 196 (156-268) pmol/L, respectively; both P < 0.001). MR-proANP and CT-proET1 levels were significantly associated with ROP ≥ stage II in univariable logistic regression models and after adjusting for co-factors, including gestational age and birth weight z-score. CONCLUSIONS MR-proANP and CT-proET1 measured on day seven of life are strongly associated with ROP ≥ stage II in very preterm infants and might improve early prediction of ROP in the future. IMPACT Plasma levels of midregional pro-atrial natriuretic peptide and C-terminal pro-endothelin-1 measured on day seven of life in very preterm infants show a strong association with development of retinopathy of prematurity ≥ stage II. Both biomarkers have the potential to improve early prediction of retinopathy of prematurity. Vasoactive peptides might allow to reduce the proportion of screened infants substantially.
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Affiliation(s)
- Roland P Neumann
- Department of Neonatology, University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.
| | - Roland Gerull
- Department of Neonatology, University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Neonatology, University Children's Hospital Inselspital Berne, Berne, Switzerland
| | - Pascal W Hasler
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Sven Wellmann
- Department of Neonatology, University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Sven M Schulzke
- Department of Neonatology, University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
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Zuluaga-Botero C, Cantor E, Bonilla F, Robayo-Velásquez JF, Martínez-Blanco AM. The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city. Indian J Ophthalmol 2023; 71:3494-3500. [PMID: 37870013 PMCID: PMC10752320 DOI: 10.4103/ijo.ijo_889_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/30/2022] [Accepted: 10/25/2022] [Indexed: 10/24/2023] Open
Abstract
Purpose To evaluate the effects of long-standing early detection program in the incidence and trends of severe retinopathy of prematurity (ROP) in Cali, Colombia. Methods This was a retrospective cohort study of infants included in an ROP prevention, early detection, and prompt treatment program, from January 01, 2002, to December 31, 2021 (20 years). Infants with gestational age (GA) <37 weeks or birth weight (BW) <2000 g and those with known ROP risk factors were screened. The incidence of severe ROP was calculated, and the average annual percent change (AAPC) was estimated through a joinpoint model. Results 16,580 infants were screened, with an average GA and BW of 31.4 ± 2.8 weeks and 1526.5 ± 56.7 g, respectively. The incidence of severe ROP was 2.69% (446 cases, 95% confidence interval [95%CI]: 2.45%; 2.95%), with an average annual decrease of - 14% (AAPC, 95%CI: -16.3%; -11.6%) from 13.6% in 2002 to 0.7% in 2021. In infants with GA <32 weeks, the incidence was 5.21%. A significant reduction in the risk of ROP was observed with increasing GA and BW (P < 0.05). Among the cases with severe ROP, 6.5% (29/446) had a GA ≥32 weeks with a maximum of 37 weeks; only 0.4% (2/446) of the detected infants had a BW >2000 g. Conclusion Awareness and screening as part of the early detection program to prevent ROP has shown a significant decline in the incidence of severe ROP over time. Screening infants with GA <32 weeks or BW <2000 g and preterm infants (<37 weeks) with risk factors may be a feasible decision for resource optimization.
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Affiliation(s)
- Claudia Zuluaga-Botero
- Research Group Visión and Ocular Health Research Group/Vision y Salud Ocular, VISOC, Service of Ophthalmology, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
- Department of Ophthalmology, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia
- Instituto Para Niños Ciegos y Sordos del Valle del Cauca, Cali, Colombia
| | - Erika Cantor
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Francisco Bonilla
- Research Group Visión and Ocular Health Research Group/Vision y Salud Ocular, VISOC, Service of Ophthalmology, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
- Department of Ophthalmology, Institute for Clinical Research Education (ICRE), University of Pittsburgh, Pittsburgh, PA, United States
| | - Juan F Robayo-Velásquez
- Research Group Visión and Ocular Health Research Group/Vision y Salud Ocular, VISOC, Service of Ophthalmology, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
| | - Alexander M Martínez-Blanco
- Research Group Visión and Ocular Health Research Group/Vision y Salud Ocular, VISOC, Service of Ophthalmology, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia
- Department of Ophthalmology, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia
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Ge J, Luo C, Lei M, Shi Z, Cheng X, Zhao M, Zhao Y, Song M, Ding W, Wang M, Cao W, Mao F, Han S, Xu Q, Wang J, Qin H, Wang L, Zhang Q. Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28-31 Weeks' Gestation. Front Pediatr 2021; 9:783900. [PMID: 35141177 PMCID: PMC8819076 DOI: 10.3389/fped.2021.783900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/07/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE In the early life of preterm infants, the relationship between heart function and length of hospitalization is unclear. This study aims to examine the association between serum NT-proBNP level on the 7th day (NT-proBNP7) after birth and length of hospitalization among preterm infants. METHODS A retrospective cohort study was conducted. Patients included 709 preterm infants born at 28-31 weeks' gestational age (GA) admitted to the NICU of the First Affiliated Hospital of Zhengzhou University between December 20, 2016, to April 31, 2021. Main outcome: Late discharge (postmenstrual age at discharge was in the fourth quartile (highest) among infants born at the same GA). Exposure factor: NT-proBNP7. RESULTS We observed increased prevalence ratios for late discharge among the tertile of logarithm of NT-proBNP7 level (LnNT-proBNP7) which was positive. Compared with the lowest tertile, infants in the highest tertile of LnNT-proBNP7 had an 8.4-fold increased probability of late discharge, and the results were consistent for the subgroups. Next, a non-linear (S-shaped) relationship between LnNT-proBNP7 and late discharge was observed, whose turning points were 7.5 and 9. The effect sizes and the confidence intervals on the left of the first turning point, between two turning points and on the right of the second turning point, were 0.6 (95% CI, 0.2-1.6), 5.0 (95% CI, 2.4-10.6), and 1.1 (95% CI, 0.2-6.1), respectively. In addition, the prevalence of BPD, NEC, nosocomial infection, or any of them was highest in the group of LnNT-proBNP7 ≥ 9, lowest in the group of LnNT-proBNP7 < 7.5. CONCLUSION Higher NT-proBNP7 levels were associated with longer hospitalization. The relationship between LnNT-proBNP7 and late discharge was S-shaped. LnNT-proBNP7 was positively related with late discharge when LnNT-proBNP7 was between 7.5 and 9.
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Affiliation(s)
- Jian Ge
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chenghan Luo
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengyuan Lei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanyang Shi
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Xinru Cheng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Min Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanting Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Min Song
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenqian Ding
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenjun Cao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengxia Mao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Suge Han
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianya Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junbo Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haoqi Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qian Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
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