280 Antenatal Betamethasone (ANB) May Prevent Severe Retinopathy of Prematurity (ROP) in Very Low Birth Weight (VLBW) Infants

Abstract

Background: Previous studies have shown that prenatal steroids may indirectly reduce the incidence of severe ROP, by decreasing the incidence of RDS and oxygen use.Aim: To determine wether ANB may directly affect the incidence of severe ROP in VLBW infantsMethods: Prospective perinatal data were collected in 106 VLBW neonates with a gestational age of <30 weeks who had RDS, required mechanical ventilation and received exogenous surfactant. All infants underwent serial eye examinations by the same pediatric ophthalmologist who was not aware whether the infants had received or not ANB. Pearson Chi-Square and Logistic Regression Analysis were used to evaluate the relationship between ANB exposure (one or more doses) and threshold ROP, as well as the relationship between other perinatal variables and threshold ROP.Results: Threshold ROP was developed in only 5 (8%) out of the 65 infants who received one or more doses of ANB compared to 12 (29%) out of the 41 controls (p<.005). Multivariate logistic regression analysis showed that ANB was independently associated with a decreased incidence of threshold ROP (RR=0.28, 95% CI=0.14–0.79), while birth weight <1000g (RR=4.9, 95% CI=1.8–28.4), gestational age <27 weeks (RR=4.7, 95% CI=2.1–24.8), mechanical ventilation >7 days (RR=4.1, 95% CI=1.8–30.6) and bronchopulmonary dysplasia (RR=3.5, 95% CI=1.2–28.7) were independently associated with an increased incidence of threshold ROP.Conclusions: ANB may directly reduce the incidence of severe ROP in VLBW infants, probably by enhancing fetal antioxidant activity and/or by preventing early retinal ischemia through stabilization of arterial blood pressure.