Complete Blood Count Parameters As Biomarkers of Retinopathy of Prematurity: a Portuguese Multicenter Study

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2023 May 2

PMID 37129632

Authors

Mariza Fevereiro-Martins

Ana Carolina Santos

Carlos Marques-Neves

Hercilia Guimaraes

Manuel Bicho

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP).

Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed.

Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression.

Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.

Citing Articles

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Fetal Hemoglobin as a Predictive Biomarker for Retinopathy of Prematurity: A Prospective Multicenter Cohort Study in Portugal.

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References

Vadlapatla R, Vadlapudi A, Mitra A . Hypoxia-inducible factor-1 (HIF-1): a potential target for intervention in ocular neovascular diseases. Curr Drug Targets. 2013; 14(8):919-35. PMC: 4407697. DOI: 10.2174/13894501113149990015. View

Tao Y, Dong Y, Lu C, Yang W, Li Q . Relationship between mean platelet volume and retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2015; 253(10):1791-4. DOI: 10.1007/s00417-015-2972-8. View

Condon M, Kim J, Deitch E, Machiedo G, Spolarics Z . Appearance of an erythrocyte population with decreased deformability and hemoglobin content following sepsis. Am J Physiol Heart Circ Physiol. 2003; 284(6):H2177-84. DOI: 10.1152/ajpheart.01069.2002. View

Unsal A, Key O, Guler D, Kurt Omurlu I, Anik A, Demirci B . Can Complete Blood Count Parameters Predict Retinopathy of Prematurity?. Turk J Ophthalmol. 2020; 50(2):87-93. PMC: 7204894. DOI: 10.4274/tjo.galenos.2019.45313. View

Stark A, Dammann C, Nielsen H, Volpe M . A Pathogenic Relationship of Bronchopulmonary Dysplasia and Retinopathy of Prematurity? A Review of Angiogenic Mediators in Both Diseases. Front Pediatr. 2018; 6:125. PMC: 6008318. DOI: 10.3389/fped.2018.00125. View

Schroeder J, Chichester K, Bieneman A . Human basophils secrete IL-3: evidence of autocrine priming for phenotypic and functional responses in allergic disease. J Immunol. 2009; 182(4):2432-8. PMC: 2704022. DOI: 10.4049/jimmunol.0801782. View

Lenhartova N, Matasova K, Lasabova Z, Javorka K, Calkovska A . Impact of early aggressive nutrition on retinal development in premature infants. Physiol Res. 2017; 66(Suppl 2):S215-S226. DOI: 10.33549/physiolres.933677. View

. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003; 121(12):1684-94. DOI: 10.1001/archopht.121.12.1684. View

Tan W, Li B, Wang Z, Zou J, Jia Y, Yoshida S . Novel Potential Biomarkers for Retinopathy of Prematurity. Front Med (Lausanne). 2022; 9:840030. PMC: 8848752. DOI: 10.3389/fmed.2022.840030. View

10.

Geaghan S . Hematologic values and appearances in the healthy fetus, neonate, and child. Clin Lab Med. 1999; 19(1):1-37, v. View

11.

Kim S, Port A, Swan R, Campbell J, Paul Chan R, Chiang M . Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018; 63(5):618-637. PMC: 6089661. DOI: 10.1016/j.survophthal.2018.04.002. View

12.

Niranjan H, Kumar Reddy K, Benakappa N, Murthy K, Shivananda S, Veeranna V . Role of hematological parameters in predicting retinopathy of prematurity (ROP) in preterm neonates. Indian J Pediatr. 2013; 80(9):726-30. DOI: 10.1007/s12098-013-0986-y. View

13.

Ahmadpour-Kacho M, Jashni Motlagh A, Rasoulinejad S, Jahangir T, Bijani A, Pasha Y . Correlation between hyperglycemia and retinopathy of prematurity. Pediatr Int. 2014; 56(5):726-30. DOI: 10.1111/ped.12371. View

14.

Coshal H, Mukerji A, Lemyre B, Ng E, Alvaro R, Ethier G . Characteristics and outcomes of preterm neonates according to number of doses of surfactant received. J Perinatol. 2020; 41(1):39-46. PMC: 7424238. DOI: 10.1038/s41372-020-00779-9. View

15.

Hengartner T, Adams M, Pfister R, Snyers D, McDougall J, Waldvogel S . Associations between Red Blood Cell and Platelet Transfusions and Retinopathy of Prematurity. Neonatology. 2020; :1-7. PMC: 7845415. DOI: 10.1159/000512020. View

16.

Parrozzani R, Nacci E, Bini S, Marchione G, Salvadori S, Nardo D . Severe retinopathy of prematurity is associated with early post-natal low platelet count. Sci Rep. 2021; 11(1):891. PMC: 7807000. DOI: 10.1038/s41598-020-79535-0. View

17.

Kalpathy-Cramer J, Campbell J, Erdogmus D, Tian P, Kedarisetti D, Moleta C . Plus Disease in Retinopathy of Prematurity: Improving Diagnosis by Ranking Disease Severity and Using Quantitative Image Analysis. Ophthalmology. 2016; 123(11):2345-2351. PMC: 5077696. DOI: 10.1016/j.ophtha.2016.07.020. View

18.

Marone G, Gambardella A, Mattei F, Mancini J, Schiavoni G, Varricchi G . Basophils in Tumor Microenvironment and Surroundings. Adv Exp Med Biol. 2020; 1224:21-34. DOI: 10.1007/978-3-030-35723-8_2. View

19.

Hartnett M, Morrison M, Smith S, Yanovitch T, Young T, Colaizy T . Genetic variants associated with severe retinopathy of prematurity in extremely low birth weight infants. Invest Ophthalmol Vis Sci. 2014; 55(10):6194-203. PMC: 4188045. DOI: 10.1167/iovs.14-14841. View

20.

Comez A, Yurttutan S, Seringec Akkececi N, Bozkaya A, Kokusari G, Evgin I . Red cell distribution width and its association with retinopathy of prematurity. Int Ophthalmol. 2020; 41(2):699-706. DOI: 10.1007/s10792-020-01627-7. View