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The absolute nucleated red blood cell (aNRBC) count at birth is not an indicator for retinopathy of prematurity (ROP)

Abstract

Objective:

To establish the reproducibility of a published observation by Lubetzky et al. that infants affected by retinopathy of prematurity (ROP) had higher absolute nucleated red blood cell (aNRBC) counts than those unaffected. The authors suggested that infants exposed to intrauterine hypoxia are at higher risk for ROP. We attempted to verify this reported relationship of ROP with the aNRBCs at birth and hypothesized that infants with ROP stage 2 have higher aNRBCs at birth.

Study Design:

We report a retrospective 1:1 case matched analysis where cases had a diagnosis of grade II ROP or worse and matching infants had confirmed stage I or no ROP. Eligible infants had birth weights of 501 to 1500 g and were discharged alive from 1st January 2000 to 31st December 2008. Wilcoxon's signed rank test was performed for continuous comparisons. This study was approved by two local Institutional Review Boards.

Result:

In all, 66 matched pairs were analyzed. When comparing aNRBCs there was no statistically significant relationship (w=−0.265, P=0.791) between the ROP affected group (M=4550, s.d.=7342) and the unaffected group (M=5287, s.d.=6524).

Conclusion:

We are unable to support the previously reported relationship of aNRBCs with ROP. Our population was three times larger, had higher aNRBCs and less retinopathy than previously reported. A biological principle of cause and effect or predisposition to ROP as reflected by aNRBCs should have been easier for us to demonstrate, if it existed.

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References

  1. Lubetzky R, Stolovitz C, Dollberg S, Mimouni FB, Salomon M, Mandel D . Nucleated red blood cells in preterm infants with retinopathy of prematurity. Pediatrics 2005; 116: 619–622.

    Article  Google Scholar 

  2. Mccolm JR, Fleck BW . Retinopathy of prematurity: causation. Semin Neonatol 2001; 6: 453–460.

    Article  CAS  Google Scholar 

  3. Silverman WA . Retrolental Fibroplasia: A Modern Parable. Grune and Stratton: New York, NY, 1980.

    Google Scholar 

  4. Kim TI, Sohn J, Pi SY, Yoon YH . Postnatal risk factors of retinopathy of prematurity. Paediatr Perinat Epidemiol 2004; 18: 130–134.

    Article  Google Scholar 

  5. Smith LE . Pathogenesis of retinopathy of prematurity. Semin Neonatol 2003; 8: 469–473.

    Article  Google Scholar 

  6. Seiberth V, Linderkamp O . Risk factors in retinopathy of prematurity. a multivariate statistical analysis. Ophthalmologica 2000; 214: 131.

    Article  CAS  Google Scholar 

  7. Hagadorn JI, Richardson DK, Schmid CH, Cole CH . Cumulative illness severity and progression from moderate to severe retinopathy of prematurity. J Perinatol 2007; 27: 502.

    Article  CAS  Google Scholar 

  8. Minior VK, Bernstein PS, Divon MY . Nucleated red blood cells in growth-restricted fetuses: associations with short-term neonatal outcome. Fetal Diagn Ther 2000; 15: 165–169.

    Article  CAS  Google Scholar 

  9. Finne PH . Erythropoietin levels in cord blood as an indicator of intrauterine hypoxia. Acta Paediatr Scand 1966; 55: 478–489.

    Article  CAS  Google Scholar 

  10. Vatansever U, Acunas B, Demir M, Karasalihoglu S, Ekuklu G, Ener S et al. Nucleated red blood cell counts and erythropoietin levels in high-risk neonates. Pediatr Int 2002; 44: 590–595.

    Article  CAS  Google Scholar 

  11. Korst LM, Phelan JP, Ahn MO, Martin GI . Nucleated red blood cells: an update on the marker for fetal asphyxia. Am J Obstet Gynecol 1996; 175: 843–846.

    Article  CAS  Google Scholar 

  12. Hermansen MC . Nucleated red blood cells in the fetus and new born. Arch Dis Child Fetal Neonatal Ed 2001; 84: 211–215.

    Article  Google Scholar 

  13. An International Committee for the Classification of Retinopathy of Prematurity. Arch Ophthalmol 2005; 123: 991.

  14. Policy statement: Section on Ophthalmology American Academy of Pediatrics American Academy of Ophthalmology American Association for Pediatric Ophthalmology and Strabismus. Pediatrics 2001; 108: 809.

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Correspondence to B T Bloom.

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Gotru, S., Ahlers-Schmidt, C., Delmore, P. et al. The absolute nucleated red blood cell (aNRBC) count at birth is not an indicator for retinopathy of prematurity (ROP). J Perinatol 33, 21–24 (2013). https://doi.org/10.1038/jp.2012.34

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