P2.H142: Intracranial hemorrhage and severity of retinopathy of prematurity in preterm infants

Background: Retinopathy of prematurity (ROP) and intracranial hemorrhage (ICH) present important challenges in preterm infants, potentially leading to blindness and impaired neurodevelopmental outcomes. Premature infants' susceptibility to ICH and ROP stems from their underdeveloped organ systems, particularly the brain and retina. Contributing factors such as low birth weight, immature blood vessel formation, and exposure to supplemental oxygen further compound these risks. Our study seeks to investigate the correlation between severe ICH and the heightened likelihood of ROP development and the necessity for anti-vascular endothelial growth factor (VEGF) injection with bevacizumab in affected cases.

Methods: A retrospective cohort study was conducted within the Neonatal Intensive Care Unit (NICU) at the University of Florida, Jacksonville. The study included preterm infants born with a gestational age of less than 28 weeks and diagnosed with ROP between 2017 and 2023. Regression analysis was employed to adjust for confounding variables.

Results: In our study, we examined 364 preterm infants diagnosed with ROP, with 8.7% (32 infants) experiencing mortality. Among the ROP patients, 15.7% (57 infants) received bevacizumab treatment, and among them, 20 patients had severe ICH. Our study revealed a significant correlation between severe ICH and ROP stages (p=0.002, Table 2). This association remained significant even after completing regression analysis and controlling for confounding variables, with an adjusted odds ratio (aOR) of 0.252 (95% CI: 0.131-0.485, p< 0.001), Table 3. Furthermore, we observed a significant association between severe ICH and infants treated with bevacizumab for severe ROP compared to those who did not receive it (p < 0.001, Table 1).

Conclusion: In our cohort of preterm infants, we identified a significant correlation between severe intracranial hemorrhage and the severity of ROP necessitating treatment with intravitreal injection of bevacizumab. These findings emphasize the necessity for additional prospective studies to validate these associations.