The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants.
BACKGROUND
Retinopathy of prematurity(ROP) is the most common serious ophthalmic disease in preterm infants. Human milk may provide a protective effect for ROP; however, beneficial effects of human milk preclude randomized trials. Therefore, we conducted a retrospective analysis comparing early postnatal nutrition with ROP development.


OBJECTIVE
Evaluate relationship between early postnatal nutriture and ROP surgery.


METHODS
Nutrition data was collected for inborn AGA infants, BW 700-1000 g. ROP surgery was the primary outcome variable. A single pediatric ophthalmologist supervised examinations. All infants received triweekly IM vitamin A as chronic lung disease prophylaxis (Tyson: NEJM, 1999).


RESULTS
BW and gestational age were 867+/-85 g and 26.3+/-1.2 weeks (n=77, mean+/-1SD). ROP surgery infants(n=11) received more parenteral nutrition, 1648 mL, and less human milk, 13.8 mL/kg-day, and vitamin E, 1.4 mg/kg-day, during the second postnatal week. Human milk was a negative predictor for ROP surgery, odds ratio=0.94. Both groups met vitamin A recommendations; however, 74% was administered via IM injections. Neither group met vitamin E recommendations.


CONCLUSIONS
Human milk feeding, parenteral nutrition volume and vitamin E intake were predictors for ROP surgery. IM vitamin A injections provided the majority of vitamin A; vitamin E administration was insufficient. Improving human milk feeding rates and vitamin dosing options may affect ROP surgery rates.
Porcelli
Peter J
PJ
Department of Pediatrics, Wake Forest University, Winston-Salem, NC 27157, United States. porcelli@wfubmc.edu
Weaver
R Grey
RG
D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008171:Lung Diseases / Q000517:prevention & control; D008895:Milk, Human; D015596:Nutrition Assessment; D010288:Parenteral Nutrition; D012178:Retinopathy of Prematurity / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies; D014801:Vitamin A / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use
D014801:Vitamin A; D014810:Vitamin E