Abstract
Aim: Retinopathy of prematurity (ROP) is a major morbidity in preterm infants causing visual impairment including blindness. Prevention and timely treatment are critical. We investigated the potential role of red blood cell (RBC) transfusions as risk factor for ROP development. Methods: Retrospective cohort study of data from 68 tertiary level neonatal intensive care units in Germany. Preterm infants born at 22 + 0 to 28 + 6 weeks of gestation between January 2009 and December 2021 were enrolled. Results: We included n = 12 565 infants. Prevalence of any ROP was 49.2% with most infants being diagnosed with stage 1 (21.5%) and 2 disease (17.2%). ROP stage 3 was present in 10.2%, stage 4 in 0.3%, and ROP requiring treatment in 6.6%. Infants with ROP had significantly more frequently a history of RBC transfusions. Adjusting for confounders, RBC transfusions were associated with increased odds of ROP (OR 1.4, p < 0.001), ROP progression (OR 2.1, p < 0.01) and ROP requiring treatment (OR 3.6, p < 0.001). Restrictive transfusion approaches correlated with decreased (OR 0.7, p < 0.001), liberal regimes with increased odds (OR 1.2, p = 0.001). Conclusion: The present study confirmed an association of RBC transfusions and ROP. Our findings emphasise the need for anaemia prevention and critical re-evaluation of transfusion practices in preterm infants.
| Original language | English |
|---|---|
| Journal | Acta Paediatrica, International Journal of Paediatrics |
| Volume | 112 |
| Issue number | 12 |
| Pages (from-to) | 2507-2515 |
| Number of pages | 9 |
| ISSN | 0803-5253 |
| DOIs | |
| Publication status | Published - 12.2023 |
Funding
This study did not receive any specific funding. The GNN registry was supported by the German Ministry of Education and Research (BMBF grant 01ER0805 and 01ER1501 to Wolfgang Göpel) and a grant by Pfizer: Investigator Research Exchange (ASPIRE) program, 2013 (to Christoph Härtel).
