Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity

Purpose To investigate predictive potential of growth and metabolic blood biomarkers in the development of milder, reversible retinopathy of prematurity (ROP) stages.Methods Biomarkers were obtained from blood samples collected every second postnatal week in a prospective, longitudinal cohort study...

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Main Authors: Gorm Greisen, Ivan Brandslund, Dorte Aalund Olsen, Carina Slidsborg, Julie Lyng Forman, Aneta Aleksandra Nielsen, Frederik Sørensen
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open Ophthalmology
Online Access:https://bmjophth.bmj.com/content/10/1/e001975.full
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author Gorm Greisen
Ivan Brandslund
Dorte Aalund Olsen
Carina Slidsborg
Julie Lyng Forman
Aneta Aleksandra Nielsen
Frederik Sørensen
author_facet Gorm Greisen
Ivan Brandslund
Dorte Aalund Olsen
Carina Slidsborg
Julie Lyng Forman
Aneta Aleksandra Nielsen
Frederik Sørensen
author_sort Gorm Greisen
collection DOAJ
description Purpose To investigate predictive potential of growth and metabolic blood biomarkers in the development of milder, reversible retinopathy of prematurity (ROP) stages.Methods Biomarkers were obtained from blood samples collected every second postnatal week in a prospective, longitudinal cohort study including 108 infants born with a gestational age (GA) <32 weeks in four hospitals in the Capital Region of Denmark, 2018–2019. ROP diagnoses were obtained from the electronic medical record system together with demographic, clinical and laboratory data. Measurement of glucose was summarised as mean and SD for every postnatal week and growth was summarised as increment in weight, head circumference (biparietal diameter) and length every postnatal week. The predictive potential of each biomarker and each marker of growth in turn were evaluated in univariate receiver operating characteristics curve analyses and in multivariate analyses including GA and small for gestational age (SGA) as known predictors.Results The strongest isolated postnatal predictor of ROP was weight gain at the second postnatal week with an area under the curve (AUC) of 0.80 (95% CI: 0.70 to 0.89). However, it only added insignificantly to the AUC (0.85; 95% CI: 0.76 to 0.93, adj. p=0.89) compared with GA and SGA alone (AUC=0.80, 95% CI: 0.70 to 0.90). Mean glucose in PNA weeks 1–4, glycaemic variability as measured by glucose SD weeks 1–3 PNA, and concentrations of adiponectin/glucose (mean) ratio were also associated with ROP diagnosis (AUCs ranging from 0.679 to 0.77) but did also not contribute significantly to the AUC compared with GA and SGA alone.Conclusions Postnatal growth and metabolic blood biomarkers were significantly associated with milder, reversible ROP, but none of these gave prediction over and above GA and SGA. Due to the small sample sizes, potential predictors could only be investigated in univariate analyses. Larger studies are needed to fully explore the predictive potential of all the biomarkers.
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spelling doaj-art-2b3cdb6494e24ecda10d01ee4af5ac8e2025-08-20T03:06:32ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-03-0110110.1136/bmjophth-2024-001975Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurityGorm Greisen0Ivan Brandslund1Dorte Aalund Olsen2Carina Slidsborg3Julie Lyng Forman4Aneta Aleksandra Nielsen5Frederik Sørensen6Department of Neonatology, Rigshospitalet, Copenhagen, DenmarkDepartment of Biochemistry and Immunology, University of Southern Denmark, Vejle County, Vejle, DenmarkDepartment of Biochemistry and Immunology, University of Southern Denmark, Vejle County, Vejle, DenmarkOphthalmology, Copenhagen University Hospital, Copenhagen, DenmarkUniversity of Copenhagen Section of Biostatistics, Kobenhavn, DenmarkDepartment of Biochemistry and Immunology, University of Southern Denmark, Vejle County, Vejle, DenmarkUniversity of Copenhagen Section of Biostatistics, Kobenhavn, DenmarkPurpose To investigate predictive potential of growth and metabolic blood biomarkers in the development of milder, reversible retinopathy of prematurity (ROP) stages.Methods Biomarkers were obtained from blood samples collected every second postnatal week in a prospective, longitudinal cohort study including 108 infants born with a gestational age (GA) <32 weeks in four hospitals in the Capital Region of Denmark, 2018–2019. ROP diagnoses were obtained from the electronic medical record system together with demographic, clinical and laboratory data. Measurement of glucose was summarised as mean and SD for every postnatal week and growth was summarised as increment in weight, head circumference (biparietal diameter) and length every postnatal week. The predictive potential of each biomarker and each marker of growth in turn were evaluated in univariate receiver operating characteristics curve analyses and in multivariate analyses including GA and small for gestational age (SGA) as known predictors.Results The strongest isolated postnatal predictor of ROP was weight gain at the second postnatal week with an area under the curve (AUC) of 0.80 (95% CI: 0.70 to 0.89). However, it only added insignificantly to the AUC (0.85; 95% CI: 0.76 to 0.93, adj. p=0.89) compared with GA and SGA alone (AUC=0.80, 95% CI: 0.70 to 0.90). Mean glucose in PNA weeks 1–4, glycaemic variability as measured by glucose SD weeks 1–3 PNA, and concentrations of adiponectin/glucose (mean) ratio were also associated with ROP diagnosis (AUCs ranging from 0.679 to 0.77) but did also not contribute significantly to the AUC compared with GA and SGA alone.Conclusions Postnatal growth and metabolic blood biomarkers were significantly associated with milder, reversible ROP, but none of these gave prediction over and above GA and SGA. Due to the small sample sizes, potential predictors could only be investigated in univariate analyses. Larger studies are needed to fully explore the predictive potential of all the biomarkers.https://bmjophth.bmj.com/content/10/1/e001975.full
spellingShingle Gorm Greisen
Ivan Brandslund
Dorte Aalund Olsen
Carina Slidsborg
Julie Lyng Forman
Aneta Aleksandra Nielsen
Frederik Sørensen
Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
BMJ Open Ophthalmology
title Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
title_full Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
title_fullStr Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
title_full_unstemmed Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
title_short Postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
title_sort postnatal growth and metabolic blood biomarkers in preterm infants developing reversible retinopathy of prematurity
url https://bmjophth.bmj.com/content/10/1/e001975.full
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