Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 1930-1938 (doi:10.1542/peds.2005-1926)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Löfqvist, C.
Right arrow Articles by Hellström, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Löfqvist, C.
Right arrow Articles by Hellström, A.
Related Collections
Right arrow Premature & Newborn

Postnatal Head Growth Deficit Among Premature Infants Parallels Retinopathy of Prematurity and Insulin-like Growth Factor-1 Deficit

Chatarina Löfqvist, PhDa,b, Eva Engström, MD, PhDa, Jon Sigurdsson, MDa, Anna-Lena Hård, MD, PhDc, Aimon Niklasson, MD, PhDa, Uwe Ewald, MDd, Gerd Holmström, MDe, Lois E. H. Smith, MD, PhDb and Ann Hellström, MD, PhDa,c

a Göteborg Pediatric Growth Research Center, Institute for Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy of Göteborg University, Göteborg, Sweden
b Department of Ophthalmology, Children's Hospital, Harvard Medical School, Boston, Massachusetts
c Department of Clinical Neurosciences, Section of Ophthalmology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
d Departments of Women's and Children's Health
e Ophthalmology, Uppsala University, Uppsala, Sweden

BACKGROUND. We hypothesized that in premature infants, retinal vascular growth retardation between birth and postmenstrual age of ~30 to 32 weeks that initiates retinopathy of prematurity is paralleled by brain growth retardation.

METHODS. In a prospective longitudinal study, we measured postnatal head growth, retinopathy of prematurity stage, protein and energy intake, severity of illness and serum insulin-like growth factor-1 levels in 58 preterm infants (mean gestational age at birth: 27.6 weeks) from birth until postmenstrual age of ~40 weeks.

RESULTS. Premature infant head growth decelerates dramatically after birth until postmenstrual age of ~30 weeks. Head growth retardation coincides with retinal vascular growth suppression. Accelerated growth follows between post menstrual ages of ~30 to 32 weeks and ~40 weeks. The degree of head growth retardation up to postmenstrual age of 31 weeks corresponds to the degree of retinopathy of prematurity and to the degree of suppression of serum levels of insulin-like growth factor-1. At postmenstrual age of 31 weeks, if a child’s head circumference SD is below –2.5, then the probability of also developing at least stage 3 retinopathy of prematurity increases fivefold compared with head circumference above –2.5 SD (32% vs 6%) suggesting parallel processes in brain and retina. Serum insulin-like growth factor-1 levels correlate positively with head circumference SD score and with the degree of retinopathy of prematurity.

CONCLUSIONS. The correlation between head and retinal growth is consistent with insulin growth factor-1 being one of the postnatal growth factors involved in this multifactorial process and also suggests that factors that contribute to retinopathy of prematurity during this critical period may also affect neurological dysfunction. Additional studies are required to establish this connection.

Key Words: retinopathy • prematurity • head growth

Abbreviations: IGF-1—insulin-like growth factor-1 • ROP—retinopathy of prematurity • PMA—postmenstrual age • CNS—central nervous system • GA—gestational age • HC—head circumference • IVH—intraventricular hemorrhage • NEC—necrotizing enterocolitis • BPD—bronchopulmonary dysplasia • BW—birth weight • SDS—SD score

Accepted Nov 23, 2005.




This article has been cited by other articles:


Home page
 IOVSHome page
L. E. H. Smith
Through The Eyes of a Child: Understanding Retinopathy through ROP The Friedenwald Lecture
Invest. Ophthalmol. Vis. Sci., December 1, 2008; 49(12): 5177 - 5182.
[Full Text] [PDF]

Home page
 NEJMHome page
K. Beardsall, S. Vanhaesebrouck, A. L. Ogilvy-Stuart, C. Vanhole, C. R. Palmer, M. van Weissenbruch, P. Midgley, M. Thompson, M. Thio, L. Cornette, et al.
Early Insulin Therapy in Very-Low-Birth-Weight Infants
N. Engl. J. Med., October 30, 2008; 359(18): 1873 - 1884.
[Abstract] [Full Text] [PDF]

Home page
 J Trop PediatrHome page
M. G. Oliveira, R. C. Silveira, and R. S. Procianoy
Growth of Very Low Birth Weight Infants at 12 Months Corrected Age in Southern Brazil
J Trop Pediatr, February 1, 2008; 54(1): 36 - 42.
[Abstract] [Full Text] [PDF]

Home page
 Proc. Natl. Acad. Sci. USAHome page
C. Lofqvist, J. Chen, K. M. Connor, A. C. H. Smith, C. M. Aderman, N. Liu, J. E. Pintar, T. Ludwig, A. Hellstrom, and L. E. H. Smith
From the Cover: IGFBP3 suppresses retinopathy through suppression of oxygen-induced vessel loss and promotion of vascular regrowth
PNAS, June 19, 2007; 104(25): 10589 - 10594.
[Abstract] [Full Text] [PDF]

Home page
 Proc. Natl. Acad. Sci. USAHome page
K.-H. Chang, T. Chan-Ling, E. L. McFarland, A. Afzal, H. Pan, L. C. Baxter, L. C. Shaw, S. Caballero, N. Sengupta, S. L. Calzi, et al.
IGF binding protein-3 regulates hematopoietic stem cell and endothelial precursor cell function during vascular development
PNAS, June 19, 2007; 104(25): 10595 - 10600.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. E. Msall
The retina as a window to the brain in vulnerable neonates.
Pediatrics, June 1, 2006; 117(6): 2287 - 2289.
[Full Text] [PDF]