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Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth.
Pediatrics. 2003 Nov;112(5):1016-20
Publication Type
Ann Hellström
Eva Engström
Anna-Lena Hård
Kerstin Albertsson-Wikland
Björn Carlsson
Aimon Niklasson
Chatarina Löfqvist
Elisabeth Svensson
Sture Holm
Uwe Ewald
Gerd Holmström
Lois E H Smith
Author Affiliation
Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of the Health of Women and Children, Sweden.
Pediatrics. 2003 Nov;112(5):1016-20
Publication Type
Birth weight
Bronchopulmonary Dysplasia - blood - epidemiology
Cerebral Hemorrhage - blood - epidemiology
Enterocolitis, Necrotizing - blood - epidemiology
Fetal Growth Retardation - blood
Gestational Age
Infant, Newborn
Infant, Premature - blood
Insulin-Like Growth Factor I - analysis - deficiency
Longitudinal Studies
Prospective Studies
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Retinopathy of Prematurity - blood - epidemiology
Risk factors
Severity of Illness Index
Sweden - epidemiology
OBJECTIVE: Insulin-like growth factor I (IGF-I) is necessary for normal development of retinal blood vessels in mice and humans. Because retinopathy of prematurity (ROP) is initiated by abnormal postnatal retinal development, we hypothesized that prolonged low IGF-I in premature infants might be a risk factor for ROP. DESIGN: We conducted a prospective, longitudinal study measuring serum IGF-I concentrations weekly in 84 premature infants from birth (postmenstrual ages: 24-32 weeks) until discharge from the hospital. Infants were evaluated for ROP and other morbidity of prematurity: bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). RESULTS: Low serum IGF-I values correlated with later development of ROP. The mean IGF-I +/- SEM level during postmenstrual ages 30-33 weeks was lowest with severe ROP (25 +/- 2.41 micro g/L), 29 +/- 1.76 micro g/L with moderate ROP, and 33 +/- 1.72 micro g/L with no ROP. The duration of low IGF-I also correlated strongly with the severity of ROP. The interval from birth until serum IGF-I levels reached >33 micro g/L was 23 +/- 2.6 days for no ROP, 44 +/- 4.8 days for moderate ROP, and 52 +/- 7.5 days for severe ROP. Each adjusted stepwise increase of 5 micro g/L in mean IGF-I during postmenstrual ages 30 to 33 weeks decreased the risk of proliferative ROP by 45%. Other complications (NEC, BPD, IVH) were correlated with ROP and with low IGF-I levels. The relative risk for any morbidity (ROP, BPD, IVH, or NEC) was increased 2.2-fold (95% confidence interval: 1.41-3.43) if IGF-I was
Comment In: Pediatrics. 2006 Feb;117(2):591-216452389
PubMed ID
14595040 View in PubMed
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