Ofira Zloto1, Moran Goldfinger Lerner2, Ram Mazkereth3, Abraham Spierer4, Yoav Yinon2. 1. Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ozloto@gmail.com. 2. Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3. Neonatology, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 4. Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
PURPOSE: To examine the effect of birth weight (BW) independent of gestational age (GA) on Retinopathy of prematurity (ROP) in preterm discordant twins. METHODS: A retrospective cohort study of 45 preterm twin pairs born at < 34 weeks of gestation with BW discordance of ≥ 20%. The twin pairs were divided into two groups based on BW - small or large. Rates of ROP, stage, treatment, and prognosis were compared between the two groups. Other neonatal outcomes related to prematurity were also compared between groups. RESULTS: The mean gestation age at delivery was 31.1 weeks of gestation. The rate of ROP was significantly higher among the smaller twins compared to the larger twins (8.9% vs 0% respectively, p = 0.04). All smaller twins with ROP had stage 2 disease, and all cases of ROP had resolved without treatment. Regarding neonatal morbidities, the smaller twins had longer hospitalization length (53.8 vs 39.4 days respectively, p < 0.01) and a higher rate of hypoglycemia (55.6% vs 24.4% respectively, p = 0.003), whereas the larger twins were more commonly affected by respiratory distress syndrome (59.1% vs 26.7% respectively, p = 0.002). CONCLUSION: The rate of ROP was higher among the small twins in preterm discordant twins. This may indicate that low BW rather than early GA is the main factor contributing to the development of ROP.
PURPOSE: To examine the effect of birth weight (BW) independent of gestational age (GA) on Retinopathy of prematurity (ROP) in preterm discordant twins. METHODS: A retrospective cohort study of 45 preterm twin pairs born at < 34 weeks of gestation with BW discordance of ≥ 20%. The twin pairs were divided into two groups based on BW - small or large. Rates of ROP, stage, treatment, and prognosis were compared between the two groups. Other neonatal outcomes related to prematurity were also compared between groups. RESULTS: The mean gestation age at delivery was 31.1 weeks of gestation. The rate of ROP was significantly higher among the smaller twins compared to the larger twins (8.9% vs 0% respectively, p = 0.04). All smaller twins with ROP had stage 2 disease, and all cases of ROP had resolved without treatment. Regarding neonatal morbidities, the smaller twins had longer hospitalization length (53.8 vs 39.4 days respectively, p < 0.01) and a higher rate of hypoglycemia (55.6% vs 24.4% respectively, p = 0.003), whereas the larger twins were more commonly affected by respiratory distress syndrome (59.1% vs 26.7% respectively, p = 0.002). CONCLUSION: The rate of ROP was higher among the small twins in preterm discordant twins. This may indicate that low BW rather than early GA is the main factor contributing to the development of ROP.
Entities:
Keywords:
Discordant twins; Early gestational age; Low birth weight; Retina; Retinopathy of prematurity
Authors: Péter Varga; Botond Berecz; Barbara Pete; Timea Kollár; Zsófia Magyar; Judit Jeager; Éva Romicsné Görbe; János Rigó; József Gábor Joó; Ákos Gasparics Journal: Med Sci Monit Date: 2018-06-29