Abstract:AIM: To evaluate the impact of postnatal dexamethasone therapy(PNS)on incidence and severity of retinopathy of prematurity(ROP)in premature infants. ROP is one of the most important causes of visual impairment in infants which can lead to blindness. The increased survival of extremely low birth weight and low birth weight(LBW)infants in recent years due to advances in neonatal care has produced a population of infants at very high risk of developing ROP. Not only there are controversies around the effect of antenatal and postnatal steroids(PNS)on the incidence of ROP in premature infants, the association of this agent and severity of ROP has not yet been assessed.
METHODS: A total of 115 neonates with birth weight less than 1500g and gestational age less than 29wk were selected from Children Hospital between April 2012 and June 2013 who met the criteria for entering this double blind control study. Patients were divided randomly into case and control groups and intravenous dexamethasone 0.25mg/kg/12h was administered from day 8 to day 14 of age for case group and the control group received no dexamethasone. Ophthalmologic examinations were started at 6th week and followed until resolution.
RESULTS: Of the neonates with ≤1500g birth weight admitted to neonatal intensive care unit, 69%(80/115)survived. Neonates of lower gestational age(≤25wk and 26-28wk)had an increased incidence of ROP. The incidence of ROP(stage II or higher)was 8.6% among all 58 infants enrolling this study. Severe retinopathy of prematurity was detected in 2(7.4%)of 28 neonates received PNS and 3(9.7%)of 30 neonates who did not received PNS. No significant difference was observed for ROP incidence between postnatal dexamethasone receiving versus control group infants(P=0.35). Beyond that the incidence of severe ROP(stage>II)did not have significant difference between cases(7.4%)and control(9.7%)group too(P=0.36).
CONCLUSION: Our study demonstrated that there is no marked difference between neonates received post natal dexamethasone and no receiving neonates on incidence and severity of retinopathy of prematurity. Therefore, dexamethasone which was useful in treatment of chronic lung disease in preterm infants seems be safely administered without concern about increasing risk of ROP.
