Impact of Early Postnatal Weight Gain on Retinopathy of Prematurity in Very Preterm Infants in Southwestern Ontario

Purpose: To examine the relationship between postnatal growth and development of retinopathy of prematurity (ROP) among preterm infants in southwestern Ontario. Methods: The medical records of 431 preterm infants, born between January 1, 2008, and June 1, 2015, with a gestational age (GA) of less than 31 weeks or birth weight (BW) of less than 1,250 g were reviewed. Information collected included pregnancy and birth history, neonatal characteristics, ROP status, comorbidities, and postnatal weight measurements at specified intervals. Infants diagnosed as having ROP and no ROP were compared. Results: Low weight velocity from day 7 to day 28 (P < .001), high weight velocity from birth to first day of full enteral feeding (FEF) (P < .001), long duration from birth to FEF (P < .001), and long duration from FEF to discharge/transfer (P < .001) were associated with ROP. After controlling for GA and BW, the durations, birth to FEF, and FEF to discharge/transfer remained significant (P < .05). In a multivariable logistic regression analysis adjusting for GA, bronchopulmonary dysplasia, and surgical ligation for patent ductus arteriosus, the only independent risk factor of ROP was duration from FEF to discharge/transfer (P < .05). Conclusions: Low weight velocity from day 7 to day 28 may be a useful predictor for the development of ROP but is dependent on GA and BW. A delay to reach FEF, which is associated with comorbidities of ROP, appears to be a risk factor for ROP that is independent of GA and BW.