Poor postnatal weight gain: A risk factor for severe retinopathy of prematurity

Purpose: This study aimed to investigate the relationship between rate of p ostnatal weight gain and severity of retinopathy of prematurity (ROP). Meth ods: All infants (n = 111) screened for ROP at a single tertiary intensive care nursery over a 2-year period with an estimated gestational age of 30 w eeks or less and follow-up to at least 42 weeks' postconception were includ ed. The authors performed a retrospective review of records and statistical analysis of risk factors for ROP using multivariate analysis. Results: Inf ants with severe (stage 3 or greater) ROP gained an average 10.9 g/kg per d ay in the first 6 weeks of life, compared to a mean of 9.6 g/kg per day for those with mild or no ROP (P=.04). By multiple regression, which included birth weight, gestational age, and 9 other reported risk factors, there was an association between rate of postnatal weight gain and severity of ROP ( P=.02). By stepwise regression, 4 variables were associated with ROP severi ty: estimated gestational age at birth (P =.002), rate of postnatal weight gain (P =.0002), volume of transfused erythrocytes (P =.0001), and culture- proven sepsis (P=.02). Conclusion: Poor postnatal weight gain is a risk fac tor for the development of severe (stage 3 or greater) ROP. Ophthalmologist s should take note of those infants who gain less than 50% of their birth w eight in the first 6 weeks of life.