This case-control study was conducted in a Level-3 neonatal unit. Subjects were inborn boys with birth weight <2000 g. \"Cases\" were consecutive subjects with ROP of any severity. \"Controls\" were consecutive unrelated subjects without ROP. Recipients of blood or exchange transfusions were excluded. Sixty cases (out of 98 screened) and 60 controls (out of 93 screened) were enrolled. G6PD activity (quantitative assay) as the candidate risk factor was evaluated.
Sixty cases with 60 controls [mean (SD) gestation 28.80 (2.2) and 30.60 (2.2) wk respectively] were compared. \"Cases\" had a higher median (1st, 3rd quartile) G6PD activity compared to \"controls\" [7.39 (4.7, 11.5) vs. 6.28 (4.2, 8.8) U/g Hb, p = 0.084]. G6PD activity was highest among ROP requiring treatment [8.68 (4.7, 12.3)] followed by ROP not requiring treatment [6.91 (4.4, 11.0)], followed by controls (plinear trend = 0.06). Gestation, birth weight, duration of oxygen, breastmilk feeding, and clinical sepsis were other variables associated with ROP on univariable analysis. On multivariable logistic regression, G6PD activity [Adjusted OR 1.14 (1.03, 1.25), p = 0.01] and gestation [Adjusted OR 0.74 (0.56, 0.97), p = 0.03] independently predicted ROP. C-statistic of the model was 0.76 (95% CI 0.67, 0.85).
Higher G6PD activity was independently associated with ROP after adjusting for confounders. Each 1 U/g Hb increase in G6PD increased the odds of ROP by 14%. Severer forms of ROP were associated with higher levels of G6PD activity.
方法:本病例对照研究在3级新生儿病房进行。受试者是出生体重<2000g的出生男孩。“病例”是具有任何严重程度的ROP的连续受试者。“对照”是没有ROP的连续无关受试者。排除血液或交换输血的接受者。纳入60例(98例筛查中)和60例对照(93例筛查中)。评估作为候选风险因子的G6PD活性(定量分析)。
结果:比较了60例患者和60例对照组[平均(SD)妊娠28.80(2.2)和30.60(2.2)周]。“病例”中位数较高(第一,第3四分位数)G6PD活性与“对照”[7.39(4.7,11.5)与6.28(4.2,8.8)U/gHb,p=0.084]。G6PD活性在需要治疗的ROP中最高[8.68(4.7,12.3)],其次是不需要治疗的ROP[6.91(4.4,11.0)],其次是对照组(plinear趋势=0.06)。妊娠,出生体重,氧气的持续时间,母乳喂养,单变量分析中与ROP相关的变量为临床脓毒症。在多变量逻辑回归中,G6PD活性[调整OR1.14(1.03,1.25),p=0.01]和妊娠[调整后OR0.74(0.56,0.97),p=0.03]独立预测的ROP。模型的C统计量为0.76(95%CI0.67,0.85)。
结论:在校正混杂因素后,较高的G6PD活性与ROP独立相关。G6PD中每增加1U/gHb,ROP的几率就增加14%。ROP的极端形式与较高的G6PD活性水平相关。