Erythropoietin is not a risk factor for severe retinopathy of prematurity among high risk preterm infants. (October 2021) - Bui, Kim Chi T.
Abstract: Background: Retinopathy of prematurity (ROP) is a developmental retinal vaso-proliferative disease and a leading cause of blindness in children. Early gestational age, low birth weight and unregulated oxygen exposure are the main risk factors for the development of ROP. There are conflicting reports of a possible association between recombinant Erythropoietin (rhEPO) use and an increased risk for the development of ROP. Objective: To determine whether rhEPO is an independent risk factor for the development of severe ROP among preterm infants with a gestational age of 23 to 32 weeks and a birth weight <1500 g. Methods: We performed a retrospective study of risk factors for ROP on a cohort of 1762 premature infants born between 2009 and 2014, half of whom received rhEPO. To examine the association between treated ROP and rhEPO, a propensity score (PS) analysis was performed using the inverse probability of treatment weighted (IPTW) approach. Results: The incidence of treated ROP was 7.3% (129/1762). PS analysis did not show an association between rhEPO and severe ROP needing treatment or ROP stage 2 or higher, in either the whole population or in the subgroup of babies born at 23 to 28 weeks gestation, in whom the incidence of severe ROP was the highest. Of 117 patients treated for Type 1 or worsening stage 3 ROP, 17 were first diagnosed after NICU discharge. Conclusion: Our study showed no association between Erythropoietin use and severe ROP and highlights the importance of Ophthalmology follow up after hospital discharge. Highlights: Erythropoietin administration was not associated with severe ROP. Neonatal infection, low gestation and postnatal steroids were associated with severe ROP. The incidence of severe treated ROP was 7.3% in infants born at 23 to 32 weeks GA. 25% of patients treated for ROP were treated after NICU discharge. Outpatient Ophthalmology follow up until full retinal vascularization is important.