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Anaemia during pregnancy is associated with retinopathy of prematurity

Posted:  Tuesday, July 26, 2016

Association between antenatal iron levels and onset of retinopathy of prematurity

Retinopathy of prematurity (ROP) can cause visual impairment and blindness in premature infants. Potential risk factors associated with ROP are prematurity, low birth weight (LBW), oxygen therapy, anaemia, blood transfusion, etc. However, the impact of maternal risk factors on ROP needs to be elucidated. A new study published in the journal Pediatric Neurology focused on the association between maternal iron deficiency and the development of ROP in premature or very LBW infants.

This was a retrospective cohort study, which enrolled 254 premature infants with ROP. The subjects were classified on the basis of occurrence of ROP according to the stage of development and severity. Medical records of the infants’ mothers were reviewed for iron-deficiency anaemia during pregnancy.

Iron-deficiency anaemia during pregnancy was identified in 187 mothers. There are 5 stages of development in ROP. The incidence of stage 1 ROP was high in mothers with normal iron levels during pregnancy when compared to those with iron-deficiency anaemia. Stage 2 ROP was more evident in mothers with iron-deficiency anaemia, while stages 3 and 4 ROP were not observed in mothers with normal blood iron levels during pregnancy.

Infants with stages 3 and 4 of ROP who underwent laser treatment or retinal surgery belonged to mothers with anaemia secondary to iron deficiency. Infants whose mothers had iron deficiency during pregnancy were admitted for a longer duration of time in the intensive care unit and required more blood transfusions compared to infants whose mothers had normal iron levels.

However, this study has some drawbacks. The study did not explore the impact of duration of anaemia or onset of anaemia prior to pregnancy, or the impact of the type and duration of treatment for anaemia on the risk of developing ROP. The role of factors associated with maternal and infant complications linked with the aetiology of ROP was not investigated.

In conclusion, there was a noticeable increase in the incidence of ROP in premature infants whose mothers had iron deficiency during pregnancy. Hence, treating anaemia during pregnancy with iron supplements may protect infants, especially premature infants, from ROP. Further research on the detailed analysis of mother and infant complications linked with the aetiology of ROP is required.

News source - Dai AI, Demiryürek S, Aksoy SN, Perk P, Saygili O, Güngör K. Maternal Iron Deficiency Anaemia as a Risk Factor for the Development of Retinopathy of Prematurity. Pediatric neurology. 2015 Aug 31; 53 (2):146–50.