Am J Perinatol 2000; 17(6): 291-298
DOI: 10.1055/s-2000-13437
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

DO POSTNATAL GLUCOCORTICOIDS AND RETINOPATHY OF PREMATURITY RELATE?

Jacqueline Termote1 , Nicoline E. Schalij-Delfos2 , A. Rogier T.  Donders3 , Bernard P. Cats1
  • 1Department of Neonatology, Wilhelmina Children's Hospital
  • 2F.C. Donders Institute for Ophthalmology
  • 3Centre for Biostatistics, University of Utrecht, Utrecht, The Netherlands
Further Information

Publication History

Publication Date:
31 December 2000 (online)

ABSTRACT

To study a possible relation between the use of postnatal glucocorticoids and the incidence and severity of retinopathy of prematurity (ROP), we conducted a retrospective study over a 4-year period that compared data of 161 preterm infants treated with hydrocortisone for bronchopulmonary dysplasia (BPD) with the data of 253 controls. The incidence of overall ROP was 62.7% in the hydrocortisone group and 21.3% in the control group. The incidence of severe ROP (stages 3-5) was 5% in the treatment group and 0.4% in the control group. Using logistic regression, postnatal hydrocortisone therapy was not associated with an increased risk for ROP or severe ROP (OR 1.387, 95% confidence interval 0.773-2.489, p = 0.272 and OR 4.112, 95% C.I. 0.44-38.37, p = 0.16, respectively). Also, in a subgroup of extremely low-birth-weight infants (<1000 g), postnatal hydrocortisone had no influence on the incidence of (severe) ROP. In the infants with ROP (n = 155), only prolonged use of postnatal hydrocortisone was associated with an increased risk for severe ROP (OR 1.02, 95% C.I. 1.00-1.03, p = 0.03). In this study postnatal use of hydrocortisone was not associated with an increased risk for (severe) ROP. However, in infants already suffering from ROP, prolonged treatment with hydrocortisone concurred with an increased risk for severe ROP.

REFERENCES

  • 1 Liggings G C, Howie R N. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants.  Pediatrics . 1972;  50 515-525
  • 2 Kramer L I, Hultzen C. The role of steroids in early bronchopulmonary dysplasia.  Pediatr Res . 1978;  12 564A
  • 3 Rush M G, Hazinski T A. Current therapy of bronchopulmonary dysplasia.  Clin Perinatol . 1992;  19 563-590
  • 4 DeJonge M H, Khuntia A, Maisels M J, Bandagi A. Bilirubin levels and severe retinopathy of prematurity in infants with estimated gestational ages of 23 to 26 weeks.  J Pediatr . 1999;  135 102-104
  • 5 Ramanathan R, Siassi B, deLemos R. Severe retinopathy of prematurity in extremely low birth weight infants after short-term dexamethasone therapy.  J Perinatol . 1995;  15 178-182
  • 6 Batton D G, Roberts C, Trese M, Maisels M J. Severe retinopathy of prematurity and steroid exposure.  Pediatrics . 1992;  90 534-536
  • 7 Sobel D B, Philip A GS. Prolonged dexamethasone therapy reduces the incidence of cryotherapy for retinopathy of prematurity in infants of less than 1 kilogram birth weight with bronchopulmonary dysplasia.  Pediatrics . 1992;  90 529-533
  • 8 Cats B P, Tan K W P E. Retinopathy of prematurity: review of a four-year period.  Br J Ophthalmol . 1985;  69 500-503
  • 9 Tan K W P E, Cats B P. Timely incidence of retinopathy of prematurity (ROP) and its consequences for the screening strategy.  Am J Perinat . 1989;  6 337-340
  • 10 Schalij-Delfos N E, Zijlmans B LM, Wittebol-Post D, Tan K W P E, Cats B P. Screening for retinopathy of prematurity: do former guidelines still apply?.  J Pediatr Ophthalmol Strabismus . 1996;  33 35-38
  • 11 Committee for the classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity II: the classification of retinal detachment.  Arch Ophthalmol . 1987;  105 906-912
  • 12 Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicentral trial of cryotherapy for retinopathy of prematurity: 3 month outcome.  Arch Ophthalmol . 1990;  108 195-204
  • 13 Hosner D W, Lemeshow S. Applied Logistic Regression.  New York: John Wiley and Sons; 1989
  • 14 Higgins R D. Endothelin-1 and hyperoxid injury to endothelial cells. In: Reibaldi A, Di Piétro M, Scuderi A, Malerba E, eds. Progress in Retinopathy of Prematurity Amsterdam/New York: Kugler Publications 1997: 101-104
  • 15 Randhawa P, Hass M, Frank L, Massaro D. Dexamethasone increases superoxide dismutase activity in serum-free rat fetal lung organ cultures.  Pediatr Res . 1986;  20 895-898
  • 16 Folkman J, Ingber D E. Angiostatic steroids.  Ann Surg . 1987;  206 374-383
  • 17 Rotschild T, Nandgaonkar B, Yu K, Higgins R D. Dexamethasone reduces oxygen induced retinopathy in a mouse model.  Pediatr Res . 1999;  46 94-100
  • 18 Yossuck P, Yan Y, Tadesse M, Higgins R D. Critical effect of timing of dexametasone on oxygen-induced retinopathy.  Pediatr Res . 1999;  45 72A
  • 19 Ohlsson A, Calvert S A, Hosking M, Shennan A T. Randomized controlled trial of dexamethasone treatment in very-low-birth-weight infants with ventilator-dependent chronic lung disease.  Acta Paediatr . 1992;  81 751-756
  • 20 The Cochrane Neonatal Collaborative Review Group. Postnatal (< 96 hours) corticosteroids for preventing chronic lung disease in preterm infants Available at: http://www.nichd.nih.gov/cochraneneonatal/Early. Accessed March 3 2000
  • 21 The Cochrane Neonatal Collaborative Review Group. Early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants Available at: http://www.nichd.nih.gov/cochraneneonatal/Moderately. Accessed March 3 2000
  • 22 The Cochrane Neonatal Collaborative Review Group. (> 3 Weeks) postnatal corticosteroids for chronic lung disease in preterm infants Available at: http://www.nichd.nih.gov/cochraneneonatal/Delayed. Accessed March 3 2000
  • 23 Aubert L, Schmitt A, Fresson J. Impact of postnatal dexamethasone on the incidence and severity of retinopathy of prematurity in the surfactant era.  Pediatr Res . 1999;  45 183A
  • 24 Ehrenkrantz R. Steroids, chronic lung disease and retinopathy of prematurity.  Pediatrics . 1992;  90 647-648
  • 25 Avery G, Fletcher A, Kaplan M, Brudno S. Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia.  Pediatrics . 1985;  75 106-111
  • 26 Cummings J J, D'Eugenio D B, Gross S J. A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia.  N Engl J Med . 1989;  320 1505-1510
  • 27 Keith C G, Doyle L W. Retinopathy of prematurity in extremely low birth weight infants.  Pediatrics . 1995;  95 42-45
    >