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Risk Factors for Severe ROP
Association of Postnatal Dexametha-sone Use and Fungal Sepsis in the Development of Severe Retinopathy of Prematurity and Progression to Laser Therapy in Extremely Low birth weight Infants. Parupia MF and Dhanireddy R. J Perinatol 2001 (June); 21: 242-7.
Records of all < 1000 gram birth weight infants (n = 158) admitted to LSU Health Sciences Center between July 1, 1996 and June 30, 1999 were reviewed. 58% received antenatal steroids, and 68% received postnatal steroids. Sepsis developed in 34% and fungal sepsis in 14%. The Incidence of ROP was 77%, and severe ROP (>/= stage 3) 52%. The development of threshold ROP and the requirement for laser therapy were higher in Caucasians (p = 0.0002) and infants with fungal sepsis (p = 0.001). Antenatal steroids had no effect on severity of ROP or the need for laser treatment. Postnatal dexamethasone use was significantly associated with fungal sepsis (13/14 = 93%), and was independently associated with severe ROP (OR = 1.2, 1.04 – 1.33).
Comment. More bad news about postnatal dexamethasone treatment … if appears that it increases your risk of fungal sepsis and of severe ROP. The list of potential problems with this treatment keeps growing. It also includes hypertension, hyperglycemia, GI bleeding, small bowel perforations, poor growth, and poor neuro-developmental outcomes. The next article also deals with complications of postnatal dexamethasone treatment.