Study on the correlation between maternal iron deficiency anemia and ROP in premature or low birth weight infants

Abstract:

AIM:To explore the correlation between maternal iron deficiency anemia and retinopathy of prematurity(ROP)in premature infants or low birth weight infants so that to provide possible scientific basis for the prevention and control of ROP.

METHODS: This study was a case-control study. The clinical data of 317 premature or low birth weight infants who were diagnosed with ROP and their mothers in our hospital during January 2019 to July 2021 due to ROP screening for the first time(about 30d after birth)were analyzed. The relationship between maternal iron deficiency anemia and ROP and its stages were observed. And the relationship between Hb, blood value characteristics, mean gestational age, gestational weeks, infant birth weight of maternal iron deficiency anemia and ROP stage.

RESULTS: There were 235 mothers(74.1%)with iron deficiency anemia, 82 mothers(25.9%)without iron deficiency. Among them, there were 194 mothers(82.6%)with mild anemia according to anemia classification, 119 cases with stage Ⅰ ROP and 75 cases with stage Ⅱ ROP. There were 39 mothers(16.6%)with moderate anemia, 8 cases with stage Ⅱ ROP, 22 cases with stage Ⅲ ROP and 9 cases with stage Ⅳ ROP. There were 2 mothers(0.9%)of severe anemia, all of whom had stage Ⅳ ROP. No children with stage Ⅴ or threshold ROP and mothers with very severe anemia were found in this study. Compared with mothers with iron deficiency anemia, premature infants or low birth weight infants with normal iron levels were more likely to have stage Ⅰ ROP, but stage Ⅱ ROP was more pronounced in mothers with iron deficiency anemia, and the differences were statistically significant(all P<0.05). Stage Ⅲ and stage Ⅳ ROP was not observed in the mothers with normal serum iron, but was 9.4% and 4.7% in the mothers with iron deficiency anemia, respectively. The differences were statistically significant(P<0.05). Stage Ⅴ and threshold lesions ROP was not observed in preterm or low birth weight infants in mothers with normal serum iron values or iron deficiency anemia. Compared with mothers with normal iron levels, mothers with iron deficiency anemia had significantly lower hemoglobin, hematocrit, mean erythrocyte volume, serum iron and ferritin levels. At the same time, the higher mean gestational age, mean shorter gestational week and mean lower birth weight in the mothers with iron deficiency anemia, and the differences were statistically significant(all P<0.05).

CONCLUSION:Pregnant iron-deficiency anemia is associated with the occurrence and development of ROP in premature or low birth weight infants. The more severe maternal anemia, the higher maybe stage of ROP. Therefore, monitoring and supplementation of iron during pregnancy can effectively prevent and reduce the risk of ROP.

Key words:iron deficiency anemia; retinopathy of prematurity(ROP); premature infants; low birth weight infants