The association between red blood cell transfusion timing and the development of retinopathy of prematurity: Application of the two-phase theory.

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-02-26 DOI:10.1111/aos.17471

Salma El Emrani, Lizanne A Derks, Angela M Tjiam, Michaela van Bohemen, Jacqueline U M Termote, Lotte E van der Meeren, Irwin K M Reiss, H Rob Taal, Enrico Lopriore, Nicoline E Schalij-Delfos

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引用次数: 0

Abstract

Purpose: Red blood cell (RBC) transfusions are believed to be associated with retinopathy of prematurity (ROP), but the underlying mechanism is not fully understood, partly due to the lack of information on RBC transfusion timing. The aim was to determine the association between the timing and amount of RBC transfusions and the development and severity of ROP.

Methods: This retrospective dual-center cohort study included 1177 neonates born in 2004-2022 with a gestational age at birth ≤28 weeks. Primary outcomes were any stage ROP and severe ROP based on maximum staging. Phase I of ROP was defined as ≤32.0 weeks postmenstrual age and phase II as >32.0 weeks postmenstrual age. Logistic regression analyses were adjusted for gestational age at birth, small for gestational age, mechanical ventilation duration, postnatal corticosteroids, sepsis, and necrotizing enterocolitis.

Results: Multivariate analysis showed independent associations with severe ROP for RBC transfusion (OR 5.1; 95% CI 1.8-14.3), number of RBC transfusions (OR 1.2; 95% CI 1.1-1.3), RBC transfusion in phase I (OR 2.5; 95% CI 1.2-5.3), number of RBC transfusions in phase I (OR 1.2; 95% CI 1.0-1.3), RBC transfusion in phase II (OR 4.1; 95% CI 2.7-6.3) and number of RBC transfusions in phase II (OR 1.9; 95% CI 1.5-2.4).

Conclusion: Based on maximum ROP staging, RBC transfusions in phases I and II are both associated with a high risk of severe ROP. A randomized controlled trial is urgently needed to determine the potential effect of RBC transfusions in phase II on ROP progression.

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红细胞输血时机与早产儿视网膜病变发展的关系：两期理论的应用。

目的：红细胞（RBC）输注被认为与早产儿视网膜病变（ROP）有关，但其潜在机制尚不完全清楚，部分原因是缺乏红细胞输注时机的信息。目的是确定红细胞输注的时间和数量与ROP的发展和严重程度之间的关系。方法：这项回顾性双中心队列研究纳入了2004-2022年出生、出生胎龄≤28周的1177例新生儿。主要结局是任何阶段ROP和基于最大分期的严重ROP。第一期ROP定义为≤32.0周经后年龄，第二期定义为≤32.0周经后年龄。对出生胎龄、小胎龄、机械通气时间、产后皮质激素、败血症和坏死性小肠结肠炎进行了Logistic回归分析。结果：多因素分析显示RBC输血与严重ROP的独立关联(OR 5.1；95% CI 1.8-14.3)、红细胞输注次数(OR 1.2；95% CI 1.1-1.3)， I期输血(OR 2.5；95% CI 1.2-5.3)， I期红细胞输注次数(OR 1.2；95% CI 1.0-1.3)， II期输血(OR 4.1；95% CI 2.7-6.3)和II期红细胞输注次数(OR 1.9；95% ci 1.5-2.4)。结论：基于最大ROP分期，I期和II期红细胞输注均与严重ROP的高风险相关。迫切需要一项随机对照试验来确定II期红细胞输注对ROP进展的潜在影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.