Retinopathy of Prematurity and Risk of Structural Brain Abnormalities on Magnetic Resonance Imaging at Term Among Infants Born at Less Than or Equal to 32 Weeks of Gestation

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-06-27 DOI:10.1016/j.jpeds.2025.114711

Shalini Roy BS , Laura Peterson MD , Beth Kline-Fath MD , Nehal A. Parikh DO, MS , Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS) Investigators

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引用次数: 0

Abstract

Objective

To determine if retinopathy of prematurity (ROP) is associated with brain abnormalities on structural magnetic resonance imaging at term-equivalent age in infants born preterm.

Study design

We prospectively recruited 395 infants born preterm born at ≤32 weeks of gestation from 5 regional Cincinnati neonatal intensive care units. Eligible infants underwent routine ROP screening and diagnosis per international screening guidelines at 31 weeks postmenstrual age or 5-6 weeks of age (whichever came later). We obtained nonsedated structural magnetic resonance imaging at 39-44 weeks postmenstrual age. Brain injury/maturational abnormality was quantified using the validated Kidokoro global brain abnormality score by a single neuroradiologist. We performed multiple linear regressions to determine the association between ROP and brain abnormality score while adjusting for several known confounders.

Results

Of the regional sample of 395 infants born preterm, 134 (33.9%) developed ROP. Among those infants with ROP, 19 (14.2%) developed severe ROP (stage 3 or requiring treatment). In multiple linear regression analyses, ROP (any severity) (

β

= 1.5 [95% CI: 0.3, 2.8]) and severe ROP (

β

= 2.3 [0.1, 4.5]) remained significantly associated with global brain abnormality score, independent of multiple confounders. In secondary analyses, ROP was significantly associated with cerebellar and deep nuclear gray matter but not white matter or cortical gray matter abnormalities.

Conclusions

In our regional cohort of infants born preterm, ROP, especially severe ROP, was significantly associated with global brain abnormalities at term. Such abnormalities are likely the structural correlates of later functional visual and neurodevelopmental impairments commonly attributed to ROP diagnosis.

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在妊娠≤32周出生的婴儿中，早产儿视网膜病变和足月MRI脑结构异常的风险。

目的：确定早产儿视网膜病变（ROP）是否与足月等值年龄的结构MRI脑异常有关。研究设计：我们前瞻性地从辛辛那提5个地区新生儿重症监护病房招募了395名妊娠≤32周的早产儿。符合条件的婴儿在经后31周（PMA）或5至6周（以较晚者为准）时根据国际筛查指南进行常规ROP筛查和诊断。我们在月经后39至44周进行了非镇静的结构MRI检查。脑损伤/成熟异常由一名神经放射学家使用验证的Kidokoro全球脑异常评分进行量化。我们进行了多元线性回归，以确定ROP和脑异常评分之间的关系，同时调整了几个已知的混杂因素。结果：本地区395例早产儿中，134例（33.9%）发生ROP。在ROP患儿中，19例（14.2%）发展为严重ROP（3期或需要治疗）。在多元线性回归分析中，ROP（任何严重程度）（β= 1.5 [95% CI: 0.3, 2.8]）和严重ROP （β=2.3[0.1, 4.5]）仍然与整体脑异常评分显著相关，独立于多个混杂因素。在二次分析中，ROP与小脑和深部核灰质显著相关，但与白质或皮质灰质异常无关。结论：在我们的地区早产儿队列中，ROP，特别是严重ROP，与足月时的整体大脑异常显著相关。这种异常很可能与通常归因于ROP诊断的后期功能性视觉和神经发育障碍的结构相关。

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

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.