Perinatology.  2017 Dec;28(4):127-133. 10.14734/PN.2017.28.4.127.

The Relationship between Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight Infants

Affiliations
  • 1Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea. oyk5412@wonkwang.ac.kr

Abstract


OBJECTIVE
We aimed to investigate if hyperglycemia is a risk factor of retinopathy of prematurity (ROP) in very low birth weight (VLBW) infants.
METHODS
One hundred forty-seven VLBW infants during the years 2011 through 2015 were included in this retrospective study. Glucose levels were analyzed with whole blood for three weeks after birth. Hyperglycemia was defined as the blood glucose level over 125 mg/dL. ROP patients were compared with non-ROP patients. Variables significantly related to ROP including glycemic characteristics were evaluated in a multivariate analysis.
RESULTS
ROP occurrence was associated with perinatal factors like birth weight (BW), gestational age, 5-minute Apgar score and premature rupture of membranes. It was also significantly related to neonatal factors like respiratory distress, surfactant use, bronchopulmonary dysplasia, congenital heart disease, transfusion, surgical operation, apnea, aminophylline or caffeine use, ventilator days, and admission days. In glycemic characteristics, hyperglycemia duration, average and maximum glucose level for 3 weeks after birth showed statistical significance. But, in a multivariate analysis, only BW and surfactant use were independently associated with ROP, while glycemic characteristics were not. In comparisons based on ROP severity, hyperglycemia duration, average blood glucose level of 3rd week after birth, and insulin use showed significant difference, but they were not independent factors.
CONCLUSION
In this study, hyperglycemia duration, average and maximum blood glucose level during three weeks after birth were statistically significant, but they were not independent factors associated with ROP development.

Keyword

Hyperglycemia; Retinopathy of prematurity; Infant; Very low birth weight

MeSH Terms

Aminophylline
Apgar Score
Apnea
Birth Weight
Blood Glucose
Bronchopulmonary Dysplasia
Caffeine
Gestational Age
Glucose
Heart Defects, Congenital
Humans
Hyperglycemia*
Infant*
Infant, Newborn
Infant, Very Low Birth Weight*
Insulin
Membranes
Multivariate Analysis
Parturition
Retinopathy of Prematurity*
Retrospective Studies
Risk Factors
Rupture
Ventilators, Mechanical
Aminophylline
Blood Glucose
Caffeine
Glucose
Insulin

Reference

1). Farrag HM., Cowett RM. Glucose homeostasis in the micropremie. Clin Perinatol. 2000. 27:1–22.
Article
2). Kao LS., Morris BH., Lally KP., Stewart CD., Huseby V., Kennedy KA. Hyperglycemia and morbidity and mortality in extremely low birth weight infants. J Perinatol. 2006. 26:730–6.
Article
3). Alexandrou G., Skiöld B., Karlén J., Tessma MK., Norman M., Adén U, et al. Early hyperglycemia is a risk factor for death and white matter reduction in preterm infants. Pediatrics. 2010. 125:e584–91.
Article
4). Blanco CL., Baillargeon JG., Morrison RL., Gong AK. Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities. J Perinatol. 2006. 26:737–41.
Article
5). Hellström A., Carlsson B., Niklasson A., Segnestam K., Boguszewski M., de Lacerda L, et al. IGF-I is critical for normal vascularization of the human retina. J Clin Endocrinol Metab. 2002. 87:3413–6.
Article
6). Liu PM., Fang PC., Huang CB., Kou HK., Chung MY., Yang YH, et al. Risk factors of retinopathy of prematurity in premature infants weighing less than 1600 g. Am J Perinatol. 2005. 22:115–20.
Article
7). Chavez-Valdez R., McGowan J., Cannon E., Lehmann CU. Contribution of early glycemic status in the development of severe retinopathy of prematurity in a cohort of ELBW infants. J Perinatol. 2011. 31:749–56.
Article
8). Hagadorn JI., Richardson DK., Schmid CH., Cole CH. Cumulative illness severity and progression from moderate to severe retinopathy of prematurity. J Perinatol. 2007. 27:502–9.
Article
9). Kaempf JW., Kaempf AJ., Wu Y., Stawarz M., Niemeyer J., Grunkemeier G. Hyperglycemia, insulin and slower growth velocity may increase the risk of retinopathy of prematurity. J Perinatol. 2011. 31:251–7.
Article
10). Lad EM., Hernandez-Boussard T., Morton JM., Moshfeghi DM. Incidence of retinopathy of prematurity in the United States: 1997 through 2005. Am J Ophthalmol. 2009. 148:451–8.
Article
11). Mohsen L., Abou-Alam M., El-Dib M., Labib M., Elsada M., Aly H. A prospective study on hyperglycemia and retinopathy of prematurity. J Perinatol. 2014. 34:453–7.
Article
12). Seiberth V., Linderkamp O. Risk factors in retinopathy of prematurity. A multivariate statistical analysis. Ophthalmologica. 2000. 214:131–5.
13). Stoltz Sjöström E., Lundgren P., Öhlund I., Holmström G., Hellström A., Domellöf M. Low energy intake during the first 4 weeks of life increases the risk for severe retinopathy of prematurity in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed. 2016. 101:F108–13.
14). Ying GS., Quinn GE., Wade KC., Repka MX., Baumritter A., Daniel E, et al. Predictors for the development of referral-warranted retinopathy of prematurity in the telemedicine approaches to evaluating acute-phase retinopathy of prematurity (e-ROP) study. JAMA Ophthalmol. 2015. 133:304–11.
Article
15). Aiello LP. Vascular endothelial growth factor and the eye: biochemical mechanisms of action and implications for novel therapies. Ophthalmic Res. 1997. 29:354–62.
Article
16). Clermont AC., Bursell SE. Retinal blood flow in diabetes. Microcirculation. 2007. 14:49–61.
Article
17). Bozdag S., Oguz SS., Gokmen T., Tunay Z., Tok L., Uras N, et al. Serum fructosamine and retinopathy of prematurity. Indian J Pediatr. 2011. 78:1503–9.
Article
18). Garg R., Agthe AG., Donohue PK., Lehmann CU. Hyperglycemia and retinopathy of prematurity in very low birth weight infants. J Perinatol. 2003. 23:186–94.
Article
19). Louik C., Mitchell AA., Epstein MF., Shapiro S. Risk factors for neonatal hyperglycemia associated with 10% dextrose infusion. Am J Dis Child. 1985. 139:783–6.
Article
20). Mohamed S., Murray JC., Dagle JM., Colaizy T. Hyperglycemia as a risk factor for the development of retinopathy of prematurity. BMC Pediatr. 2013. 13:78.
Article
21). Ahmadpour-Kacho M., Motlagh AJ., Rasoulinejad SA., Jahangir T., Bijani A., Pasha YZ. Correlation between hyperglycemia and retinopathy of prematurity. Pediatr Int. 2014. 56:726–30.
Article
22). Bharwani SK., Dhanireddy R. Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review. J Perinatol. 2008. 28:61–6.
Article
23). Pati NK., Maheshwari R., Pati NK., Salhan RN. Transient neonatal hyperglycemia. Indian Pediatr. 2001. 38:898–901.
24). Schlebusch H., Niesen M., Sorger M., Paffenholz I., Fahnenstich H. Blood glucose determinations in newborns: four instruments compared. Pediatr Pathol Lab Med. 1998. 18:41–8.
Article
25). Kim NH., Jung HH., Cha DR., Choi DS. Expression of vascular endothelial growth factor in response to high glucose in rat mesangial cells. J En-docrinol. 2000. 165:617–24.
Article
26). Hellström A., Smith LE., Dammann O. Retinopathy of prematurity. Lancet. 2013. 382:1445–57.
Article
27). Poulaki V., Qin W., Joussen AM., Hurlbut P., Wiegand SJ., Rudge J, et al. Acute intensive insulin therapy exacerbates diabetic blood-retinal barrier breakdown via hypoxia-inducible factor-1alpha and VEGF. J Clin Invest. 2002. 109:805–15.
28). Allegaert K., Casteels I., Cossey V., Devlieger H. Retinopathy of prematurity: any difference in risk factors between a high and low risk population? Eur J Ophthalmol. 2003. 13:784–8.
Article
29). Ertl T., Gyarmati J., Gaál V., Szabó I. Relationship between hyperglycemia and retinopathy of prematurity in very low birth weight infants. Biol Neonate. 2006. 89:56–9.
Article
30). Repka MX., Hardy RJ., Phelps DL., Summers CG. Surfactant prophylaxis and retinopathy of prematurity. Arch Ophthalmol. 1993. 111:618–20.
Article
Full Text Links
  • PN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr