Insulin-like growth factor binding protein-3 in preterm infants with retinopathy of prematurity.

Background: Retinopathy of prematurity (ROP) is the main cause of visual impairment in preterm newborn infants. Objective: This study was conducted to determine whether insulin-like growth factor binding protein -3 (IGFBP-3) is associated with proliferative ROP and has a role in pathogenesis of the disease in premature infants. Materials and Methods: A total of 71 preterm infants born at or before 32 weeks of gestation participated in this study. Studied patients consisted of 41 neonates without vaso-proliferative findings of ROP as the control group and 30 preterm infants with evidence of severe ROP in follow up eye examination as the case group. Blood samples obtained from these infants 6-8 weeks after birth and blood levels of IGFBP-3 were measured using enzyme-linked immunosorbent assay (ELISA). Results: The mean gestation age and birth weight of the studied patients were 28.2±1.6 weeks and 1120.7±197 gram in the case group and 28.4±1.6 weeks and 1189.4±454 gram in the control group (P=0.25 and P=0.44 respectively). The infants in the case group had significantly lower Apgar score at first and 5 min after birth. Insulin-like growth factor binding protein -3 (IGFBP-3) was significantly lower in the patients with proliferative ROP than the patients without ROP [592.5±472.9 vs. 995.5±422.2 ng/ml (P=0.009)]. Using a cut-off point 770.45 ng/ml for the plasma IGFBP-3, we obtained a sensitivity of 65.9% and a specificity of 66.7% in the preterm infants with vasoproliferative ROP. Conclusion: Our data demonstrated that the blood levels IGFBP-3 was significantly lower in the patients with ROP and it is suspected that IGFBP-3 deficiency in the premature infants may have a pathogenetic role in proliferative ROP.

effect of oral dextrose on pain relief of newborn infants

In comparision with children and adults pain in the newborn infants is under assessed and under managed. Recently oral sweet solutions such as sucrose has been used for painful procedures in neonates. The objective was to assess the efficacy of 25% dextrose for managing of infants pain in neonatal peripheral venepuncture. In a randomized controlled clinical trial, 60 term neonates were enrolled in the study. They were randomized to receive oral dextrose [25%] or sterile water two minutes before venepuncture. Pain reactions were scored with CRIES pain scoring system, Crying time and heart rate at five minutes after venepuncture were recorded. There were significantly lower pain score and shorter crying time in dextrose group after venepuncture [CRIES pain score: 2.23 +/- 1.45 vs 6.17 +/- 1.66 P=0.001], [Duration of crying [sec]: 2.83 +/- 1.64 vs 16.97 +/- 8.49 P=0.001] respectively. Using oral dextrose solution is a useful, non expensive and non pharmacologic method for managing pain of venepuncture in neonates