Abstract 1135 Poster Session IV, Tuesday, 5/4 (poster 254)

Retinopathy of prematurity (ROP) and intraventricular hemorrhage (IVH) are serious complications in premature infants. The incidences of ROP and IVH have been shown to correlate inversely with gestational age and birth weight. ROP can cause significant visual impairment when it is associated with proliferative disease. The etiology and pathogenesis of both diseases remain unknown. Infants at risk for ROP are also at risk for IVH. IVH and ROP are disorders of an immature vasculature. While IVH occurs most commonly at birth or less than 72 hours of age, ROP develops at 5 to 7 weeks of age. We propose the hypothesis that the presence of significant (grades 3 and 4) IVH at birth is marker for development of severe ROP (stage 3 plus and 4). Methods: We performed a retrospective review of 45 infants with severe ROP (stage 3 plus and 4) born in the period of January 1990 to December 1995. These infants received cryotherapy and/or laser therapy at Children's Hospital of Michigan, Detroit Medical Center. We determined the incidence of the different grades of IVH in 3 birth weight categories in these infants. These findings were compared to a control group of 107 infants without severe ROP. Results: There was a significant difference in incidence of grade 3 or 4 IVH in the various birth weight categories in infants with stage 3 plus or greater ROP compared to control infants. Of 45 infants with stage 3 plus or greater ROP, 51.1% (23/45) had grade 3 or 4 IVH as compared to 14.9% (16/107) control infants (p<0.01). Ten of 16 infants (62.5%) in the 500-650 gram birth weight category had severe IVH, while only 5 of 30 (16.6%) in the same birth weight without severe ROP had severe IVH (p<0.01). Eleven of 22 infants (50%) in the 651-800 gram birth weight category had severe IVH, while only 8 of 43 control infants (18.6%) in this category had severe IVH (p<0.02). The sensitivities and specificities of severe IVH in predicting the presence of proliferative ROP were 62.5% and 83.3% in the 500-650 gram birth weight category, 50.0% and 81.3% in the 651-800 gram birth weight category, and 28.5% and 91.1% in the >800 gram birth weight category, respectively. The negative predictive value of IVH as a marker of proliferative ROP ranged from 76.0% to 86.1%. In the 500-650 gram birth weight category, the odds ratio for severe IVH was 8.33. In the 651-800 gram birth weight category the odds ratio for severe IVH was 4.37 and in the >800 gram birth weight category, it was 4.13. Conclusion: Children with severe ROP have a higher incidence of severe IVH. Therefore these infants should be followed closely for early detection of and intervention for ROP.