Article Abstract

Regaining birth weight and predicting ROP—a prospective, pilot study

Authors: Anand Vinekar, Shwetha Mangalesh, Madhurya Mallavarapu, Chaitra Jayadev, Praveen Sharma, Bhujang Shetty


Background: Poor postnatal weight gain is a well-known risk factor for developing retinopathy of prematurity (ROP). Algorithms that predict ROP based on serial weight gain have not been generalizable in non-Caucasian populations. The duration taken to regain the lost weight is culturally important among Indian mothers. We report the correlation between this duration and the risk of developing ROP.
Methods: Sixty-eight Asian Indian infants born <2,000 grams at birth or <34 weeks of gestation were enrolled. The number of days taken for these infants to regain baseline birth weight (BW) was recorded. This measure was correlated with the eventual ROP outcome categorized as “no ROP”, ROP that regressed spontaneously (type 2 ROP), and ROP that required treatment (type 1).
Results: The mean BW of the cohort was 1,270±340 grams and mean gestational age (GA) was 31±2 weeks. Thirty-three infants (48.5%) developed no ROP, 20 infants (29.4%) developed type 2 ROP and 15 infants (22.1%) developed type 1 ROP. The mean number of days to regain the lost weight was 11.9+4.6, 17.9+7.9 and 26.6+12.9 days for the No ROP, type 2 and type 1 groups respectively (P<0.0001, one-way ANOVA with Boneferroni correction). Those babies who regained their BW within 10 days were at least risk of developing any stage ROP, moderate risk if they took between 11–20 days and highest risk if they took more than 21 days for developing type 2 or type 1 ROP.
Conclusions: The date when a child regains its lost BW is culturally important and easily recalled by mothers. We report the use of this simple estimate as a predictor of ROP. This method could be useful in stratifying risk and predicting the development of “treatment requiring ROP” even before 21 days of life, which is the first mandated screening visit in India.