Association of umbilical cord insulin-like growth factor 1 levels with severe retinopathy in extremely preterm infants.

Nobuhiko Nagano,Aya Okahashi,Kazumasa Fuwa,Ichiro Morioka,Koichiro Hara,Daichi Katayama,Ryoji Aoki,Takayuki Imaizumi,Takuya Akimoto,Ayako Seimiya,Midori Hijikata

doi:10.1016/j.pedneo.2022.05.015

Nobuhiko Nagano, Aya Okahashi + Show 9 more

Open Access

https://doi.org/10.1016/j.pedneo.2022.05.015

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Journal: Pediatrics & Neonatology	Publication Date: Mar 1, 2023
Citations: 2	License type: cc-by-nc-nd

Affiliation: Nihon University

Abstract

The association between umbilical cord blood insulin-like growth factor 1 (IGF-1) levels and retinopathy of prematurity (ROP) remains unclear. This study aimed to investigate whether umbilical cord blood IGF-1 levels can predict the development of severe ROP in extremely preterm infants. This hospital-based retrospective cohort study included infants born at <37 weeks gestational age (GA) between 2019 and 2021 and then classified them into the two GA groups: extremely preterm, <28 weeks and preterm infants, 28-36 weeks. Extremely preterm infants were further subclassified into two groups according to the laser treatment as follows: the severe ROP (ROP-Tx) and ROP (No ROP-Tx) groups. Median umbilical cord blood IGF-1 values were compared between the groups. Perinatal risk factors were identified by univariate and multivariate analyses. Finally, umbilical cord IGF-1 cut-off values requiring ROP treatment with laser were determined by receiver operating characteristic (ROC) curve analyses. A total of 205 infants were enrolled, with 32 being extremely preterm (ROP-Tx: n=11; No ROP-Tx: n=21) and 173 being preterm. IGF-1 levels were significantly lower in extremely preterm (13.5ng/mL) than preterm infants (36ng/mL, p<0.001). In extremely preterm infants, IGF-1 levels were significantly lower in the ROP-Tx group than the No ROP-Tx group (10 vs. 19ng/mL, respectively, p=0.024). Only GA, umbilical cord blood IGF-1 levels, birth head circumference, and birth chest circumference were identified as risk factors by univariate analysis (p<0.05). Multivariate analysis showed that only umbilical cord blood IGF-1 was an independent risk factor (odds ratio: 1.26, p=0.021). ROC curves revealed an IGF-1 cut-off value of 14ng/mL. The need of laser treatment for ROP was found to be associated with low umbilical cord blood IGF-1 levels in extremely preterm infants. Umbilical cord blood IGF-1 can be used as a biomarker for the risk of developing severe ROP.

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