ABSTRACT
Several risk factors like prematurity, hyperoxia, hyperglycemia, duration of mechanical ventilation and supplemental oxygen use have been attributed to the occurrence of retinopathy of prematurity [ROP] in low birth weight infants. Clinical Risk Index for Babies [CRIB] score have been used to assess the severity of the newborn's disease and neonatal mortality. The relation between the CRIB score and the incidence of retinopathy of prematurity is less assessed. This study was carried out to determine the relation between the CRIB score and retinopathy of prematurity in preterm infants. In a cross-sectional study all preterm infants admitted to NICU at Amirkola Children's Hospital, Northern Iran, from March 2009 to November 2012, with a birth weight less than 1500 grams and gestational age less than 28 weeks and other premature infants with birth weight 1500 to 2000 grams and gestational age 29 to 34 weeks with an unstable clinical condition, were included. The CRIB score was recorded in firs 12 hours of admission to the NICLJ. Ophthalmologic examination was done by a retinologist unaware of CRIB score. ROP classification was done according to the international classification of ROP. The CRIB score compared with presence or non-presence of ROP and its stage, progression or regression of disease. A P-value less than 005 are considered significant. One hundred and eighty [70%] neonates out of 256 neonates developed ROP. In 124 [68.88%] neonates it resolved spontaneously on serial ophthalmologic examination, but fifty-six [3 1.11%] neonates were required treatment for ROP which 42 [75%] received Avastin and 14 [25%] neonates treated with Laser. The Mean +/- SD for CRIB score in ROP group was 4.79 +/- 2.74 and in a group without ROP it was 3.78 +/- 2.00 [P0.004]. No correlation was found between the severity of ROP and CRIB score [P0.152]. The CRIB score can predict the occurrence of ROP, but can't predict its severity and progression or regression
ABSTRACT
Erythropoietin [Epo] is an essential hormone for erythropoiesis. Parenterral recombinant erythropoietin [rEpo] is effective for prevention of anemia of prematurity [AOP]. The aim of this study was to determine the effect of enteral rEpo on erythropoiesis in preterm infants. This is a randomized clinical trial [RCT] study performed on preterm infants [?1800gr birth weight and ?34 weeks gestational age [GA]]. Two groups of infants were randomly included in the study by sequential admissions. One group [n=7] received Epo [CIMBA. Cuba] 1200U/kg per week [3 days a week] plus ferrous sulfate [3-6 mg/kg/day]. The control group [n=7] received only ferrous solfate. Hemoglobin [HB], Hematocrit [Hct] reticulocyte count, serum Epo and ferritin level were measured at baseline, after 10 days and on discharge. Collected data were tested by T-test and repeated measurement and analyzed by SPSS software. Mean [SD] GA of control group [n=7] were 30.3 [0.9] weeks and Epo group [n=7] were 30.7 [2.56] [P=0.7]. The mean [SD] body weight of control group was 1392 [196] gr and Epo group 1328 [267] gr. Reticulocytes count at the end of study in Epo group was significantly more than in control groups [2.99 [1.45] vs 1.36 [0.96]] [P<0.009]. Serum mean erythropoietin level in Epo group was significantly more than in control group [18 [11] vs 8.7 [4]] [P=0.006]. Mean serum ferritin level in Epo group was lower than in control group although statically not significant [238 [78.59] vs 340 [166.51]] [P=0.4]. There was no significant difference in Hb and Hct between the two groups [P=0.3]. Oral administration of rEpo increased significantly serum Epo and reticulocytes count [stimulated erythropoiesis] but did not increase Hb and Hct in preterm infants