Retinopathy of prematurity in discordant twins: is the small twin at increased risk?
- PDF / 235,695 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 13 Downloads / 176 Views
PEDIATRICS
Retinopathy of prematurity in discordant twins: is the small twin at increased risk? Ofira Zloto 1
&
Moran Goldfinger Lerner 2 & Ram Mazkereth 3 & Abraham Spierer 1 & Yoav Yinon 2
Received: 7 October 2019 / Revised: 4 December 2019 / Accepted: 30 December 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To examine the effect of birth weight (BW) independent of gestational age (GA) on Retinopathy of prematurity (ROP) in preterm discordant twins. Methods A retrospective cohort study of 45 preterm twin pairs born at < 34 weeks of gestation with BW discordance of ≥ 20%. The twin pairs were divided into two groups based on BW – small or large. Rates of ROP, stage, treatment, and prognosis were compared between the two groups. Other neonatal outcomes related to prematurity were also compared between groups. Results The mean gestation age at delivery was 31.1 weeks of gestation. The rate of ROP was significantly higher among the smaller twins compared to the larger twins (8.9% vs 0% respectively, p = 0.04). All smaller twins with ROP had stage 2 disease, and all cases of ROP had resolved without treatment. Regarding neonatal morbidities, the smaller twins had longer hospitalization length (53.8 vs 39.4 days respectively, p < 0.01) and a higher rate of hypoglycemia (55.6% vs 24.4% respectively, p = 0.003), whereas the larger twins were more commonly affected by respiratory distress syndrome (59.1% vs 26.7% respectively, p = 0.002). Conclusion The rate of ROP was higher among the small twins in preterm discordant twins. This may indicate that low BW rather than early GA is the main factor contributing to the development of ROP. Keywords Retinopathy of prematurity . Discordant twins . Retina . Low birth weight . Early gestational age
Introduction Over the past two decades, the survival of premature infants has markedly increased in industrialized countries [1]. However, the long-term morbidity of premature infants especially those with low birth weight is still high including cerebral palsy, cognitive delay, deafness, and blindness [2–4]. Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the developing retina and is still the leading cause * Ofira Zloto [email protected] 1
Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
2
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
3
Neonatology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
of childhood blindness worldwide [5]. Globally, it is estimated that in 2010, 184,700 babies developed any stage of ROP; 20,000 of them became blind (visual acuity < 20/400) or severely visually impaired (visual acuity from < 20/200 to ≥ 20/ 400) [6]. In industrialized countries, around 32,700 babies developed any stage of ROP in 2010, and 1700 of th
Data Loading...
