Validation of an IGF1 Screening Method for Retinopathy of Pre-maturity (original) (raw)
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Preclinical Screening for Retinopathy of Prematurity Risk Using IGF1 Levels at 3 Weeks Post-Partum
PLoS ONE, 2014
Following current recommendations for preventing retinopathy of prematurity (ROP) involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight ,1500 g and/or ,32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.
2012
Abstract: Objective: Retinopathy of prematurity (ROP) is a blinding disease, initiated by the lack of retinal vascular growth after preterm birth. In Vitro, lack of insulin-like growth factor I (IGF-I) prevents normal retinal vascular growth. The present study was conducted to determine if low serum IGF-I levels in premature infants is associated with a higher incidence of retinopathy and therefore may be used as a prognostic factor for the occurrence of such events. Patients and methods: A prospective study was carried out at the neonatology intensive care unit of Cairo University in the period from June 2007 to June 2009 and included forty infants The inclusion criteria were: gestational age under 32 weeks or weight at birth < 1,500 g. Twenty healthy full term infants selected randomly during the same time period constituted the control group. Results: Of the 40 premature babies recruited, 17 (42.5%) developed some degree of retinopathy during the course of the study, among the...
2012
Objective: Retinopathy of prematurity (ROP) is a blinding disease, initiated by the lack of retinal vascular growth after preterm birth. In Vitro, lack of insulin-like growth factor I (IGF-I) prevents normal retinal vascular growth. The present study was conducted to determine if low serum IGF-I levels in premature infants is associated with a higher incidence of retinopathy and therefore may be used as a prognostic factor for the occurrence of such events. Patients and methods: A prospective study was carried out at the neonatology intensive care unit of Cairo University in the period from June 2007 to June 2009 and included forty infants The inclusion criteria were: gestational age under 32 weeks or weight at birth < 1,500 g. Twenty healthy full term infants selected randomly during the same time period constituted the control group. Results: Of the 40 premature babies recruited, 17 (42.5%) developed some degree of retinopathy during the course of the study, among the 17 cases ...
Türk Pediatri Arşivi, 2017
Aim: To determine the role of serum insulin-like growth factor-1 levels in the development of retinopathy of prematurity, which is a major cause of childhood blindness worldwide. Material and Methods: We prospectively studied newborn infants born at a postmenstrual age of <32 weeks and birth weights <1 500 gr, between January 1 st , 2015, and December 31 st , 2015. A total of 40 infants were enrolled in the study. The retinal examination time was determined in accordance with the American Academy of Pediatrics recommendations for retinopathy of prematurity screening and follow-up. Retinopathy of prematurity was classified according to the international classification of retinopathy of prematurity. Serum Insulin like growth factor 1 levels were measured serially in blood samples on the 1 st , 3 rd , 7 th , 21 st , and 28 th day. Results: Among the 40 infants, 11 (27.5%) constituted the retinopathy of prematurity group and 29 comprised the non-retinopathy of prematurity group. In the retinopathy of prematurity group, the mean gestational age and birth weight was significantly lower. The demographic features of the study cohort were similar. The duration of mechanical ventilation was significantly greater in the retinopathy of prematurity group compared with the non-retinopathy of prematurity group (p=0.036). In terms of neonatal morbidities such as respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, patent ductus arteriosus, and necrotizing enterocolitis, no differences were detected between the groups. The mean serum insulin-like growth factor-1 levels in retinopathy of prematurity group were significantly lower than those in the non-retinopathy of prematurity group at each time point (1 st , 3 rd , 7 th , 21 st , and 28 th day of postnatal life) (p=0.001). Conclusions: This study demonstrated the low serum insulin-like growth factor-1 levels was associated with retinopathy of prematurity development.
Postnatal serum insulin-like growth factor i and retinopathy of prematurity
Journal of American Association for Pediatric Ophthalmology and Strabismus, 2015
INTRODUCTION-Low serum insulin-like growth factor 1 (IGF-1) has been associated with development of severe retinopathy of prematurity (ROP), but no U.S. studies have been reported. We sought to determine the relationship between postnatal serum IGF-1 levels and severe ROP in a racially diverse U.S. cohort. METHODS-Prospective cohort study of 74 infants with birth weight (BW) <1251g and a known ROP outcome at 3 Philadelphia hospitals. Weekly postnatal filter-paper bloodspot IGF-1 assays) were measured through 42 weeks postmenstrual age (PMA). RESULTS-The cohort included 20 Caucasian, 45 black, 2 Asian, and 9 other infants; median gestational age (GA) 27.6 weeks (range 23-33); median BW 975g (range 490-1250). During PMA weeks 28 to 33, mean IGF-1 was 20.0 ng/mL(SE 0.52) for no ROP (n=46), 18.0(0.49) for stage 1 or 2 (n=23), and 17.0(0.70) for stage 3 (n=5, 2 lasered) (p=0.003). Adjustment for BW and GA showed similar results. CONCLUSION-Presence and timing of an association between low postnatal serum IGF and ROP in a racially diverse U.S. sample were found to be consistent with European cohorts. This association provides the pathophysiological basis for growth-based predictive models, which could improve efficiency of ROP screening. Keywords Insulin-like growth factor 1; Prematurity; Retinopathy of prematurity Retinopathy of prematurity (ROP) is a disease of the developing retinal vasculature and is a leading cause of blindness in children worldwide. 1-3 ROP pathogenesis is thought to involve multiple factors, including stage of retinal development and metabolic demand, retinal
Retinopathy of prematurity and serum level of insulin-like growth factor-1
Acta clinica Croatica, 2012
The aim of our study was to measure and compare serum insulin-like growth factor-1 (IGF-1) levels at postmenstrual age of 33 weeks between preterm infants with and without retinopathy of prematurity (ROP). ROP occurs in two phases. Low serum levels of IGF-1 during ROP phase 1 have been found to correlate with the severity of ROP. ROP phase 2 begins around postmenstrual week 33. We conducted a prospective cohort study to measure serum IGF-1 levels in premature infants at postmenstrual age of 33 weeks. The study included all premature infants (N = 74), gestational age < or = 33 weeks, hospitalized at Department of Neonatology, Clinical Center of Montenegro, from April 2008 to July 2009. The incidence of ROP in the study cohort was 50.7%. Infants with ROP had a significantly lower birth weight and significantly shorter gestational age. The mean level of IGF-1 at postmenstrual age of 33 weeks was 23.7 mcg/L. Study results showed that there was no significant difference in serum IGF-1...
British Journal of Ophthalmology, 2015
Aims To validate known risk factors and identify a threshold level for serum insulin-like growth factor 1 (IGF-1) in the development of severe retinopathy of prematurity (ROP) in an ethnically diverse population at a tertiary neonatal unit, 2011-2013. Methods A prospective cohort masked study was conducted. Serum IGF-1 levels at 31, 32 and 33 weeks were measured and risk factor data collected including gestational age (GA), birth weight (BW), absolute weight gain (AWG) and maternal ethnicity. The eventual ROP outcome was divided into two groups: minimal ROP (Stages 0 and 1) and severe ROP (Stage 2 or worse including Type 1 ROP). Results 36 patients were recruited: 14 had minimal ROP and 22 severe ROP. Significant differences between the groups were found in GA, BW, AWG and IGF-1 at 32 and 33 weeks. There was minimal rise in IGF-1 in Stage 2 patients and/or black patients (p=0.0013) between 32 and 33 weeks but no pragmatic threshold level of IGF-1 that could distinguish between minimal or severe ROP. Conclusions There were significant differences in GA, BW, AWG and IGF-1 at 32 and 33 weeks between those babies with severe ROP and those with minimal ROP. However, there was no threshold level of IGF-1 at a time point between 31 and 33 weeks that can be used to exclude a large proportion of babies from screening. We also found ethnic differences in IGF-1 levels with infants born to black mothers having significantly lower IGF-1 levels at 32 and 33 weeks gestation. The determination of ROP risk using IGF-1 is a race-specific phenomenon.