PEDIATRICS Vol. 90 No. 4 October 1992, pp. 534-536
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Severe Retinopathy of Prematurity and Steroid Exposure

Daniel G. Batton MD1, Connie Roberts RN, NNP1, Michael Trese MD2, and M. Jeffrey Maisels MB, BCh1

1 From The Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI.
2 From The Department of Ophthalmology, William Beaumont Hospital, Royal Oak, MI.

During a 3-year period (1988 through 1990) an increase was observed in the number of infants born at 23- to 26-weeks' gestation who required cryotherapy for severe retinopathy of prematurity (0/20, 1988; 3/14, 1989; 6/18, 1990; P = .015). Inasmuch as this was not related to improved survival, a retrospective case-control study was conducted to try to explain this observation. Of 52 surviving infants who had been born at 23 to 26 weeks' gestation, 9 required cryotherapy and the other 43 served as control subjects. There were no differences between groups in birthweight, gestational age, or the number of infants with hyaline membrane disease, intraventricular hemorrhage, or hydrocephalus. Factors related to the need for cryotherapy included patent ductus arteriosus (P = .046), mechanical ventilation for more than 21 days (P = .045), and the use of steroids for lung disease (P < .001). In this neonatal intensive care unit, steroids are administered according to the attending neonatologist's preference. Inasmuch as steroids are considered only for infants still ventilator dependent at 21 days, this group was analyzed separately (n = 36). Of the 21 factors examined, only the use of steroids for lung disease was associated with the need for cryotherapy (P < .001).

Key Words: newborns • retinopathy of prematurity • cryotherapy • steroids

Submitted on November 11, 1991
Accepted on March 3, 1992




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