title: Early nutrition and weight gain in preterm newborns and the risk of retinopathy of prematurity.
abstract: OBJECTIVE
  To identify nutritional and weight gain limitations associated with retinopathy of prematurity (ROP) severity among very preterm newborns.
  
  
  METHODS
  1180 infants <28 weeks GA at birth with ROP examination results were grouped and analyzed by quartile of weekly total calorie, carbohydrate, protein, and lipid intake, as well as growth velocity between postnatal days 7 and 28 (adjusted for GA and birth weight Z-score). ROP was categorized by development of no, mild (<prethreshold), type 2, or type 1 ROP, as well as markers of ROP severity including stage 3 ROP, zone 1 disease, and plus disease. Associations between nutritional intake and ROP severity were compared.
  
  
  RESULTS
  Greater risk for Type 1 ROP (risk/95% confidence intervals) was found for infants with lowest quartile receipt of lipids (2.1/1.1, 3.8), total calories (2.2/1.4, 3.6), and carbohydrates (1.7/1.1, 2.9). Development of zone 1 ROP was associated with lipid or total calorie intake in the lowest quartile, and development of stage 3 ROP was associated with lowest quartile of total calorie intake. Growth velocity in the lowest quartile was associated with increased risk of any ROP, including type 1 ROP.
  
  
  CONCLUSIONS
  The risk of developing severe ROP in extremely premature infants might be reduced by improving nutritional support, specifically targeting lipids and total calories, and perhaps by improving weight gain.
authors.affiliation: Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. deborah.vanderveen@childrens.harvard.edu
authors.forename: Deborah K
authors.initials: DK
authors.lastname: VanderVeen
authors.forename: Camilia R
authors.initials: CR
authors.lastname: Martin
authors.forename: Reshma
authors.initials: R
authors.lastname: Mehendale
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: Olaf
authors.initials: O
authors.lastname: Dammann
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D062071:Infant, Extremely Premature / Q000502:physiology*; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000503:physiopathology*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D013997:Time Factors; D015430:Weight Gain / Q000502:physiology*