Skip to main content
Log in

Surfactant replacement therapy: A new risk factor in developing retinopathy of prematurity?

  • Neonatology
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

We documented the prevalence of retinopathy of prematurity (ROP) in a group of 46 infants suffering from a moderate or severe respiratory distress syndrome and treated with surfactant replacement therapy (SRT) and 61 controls admitted in the year prior to the institution of SRT. Mortality in the treatment group was lower than in the control group (15.5% versus 23.8;P=0.29). The ROP prevalence in the treatment group was 47.8% and in the control group was 47.8% and in the control group 27.9%. To analyse the contribution of SRT alone to the prevalence of ROP, multivariate analysis using logistic regression technique was used. The odds ratio for SRT was 5.2 with a 95% confidence interval of 1.3–20.7,P=0.02. The prevalence of severe ROP in the surfactant treated group was not increased compared to the control group. From our data we conclude that SRT increases the risk of developing ROP but is not associated with more severe forms of ROP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

NICU :

neonatal intensive care unit

RDS :

respiratory distress syndrome

ROP :

retinopathy of prematurity

SRT :

surfactant replacement therapy

References

  1. Avery GB, Glass P (1988) Retinopathy of prematurity; what causes it? Clin Perinatol 15(4):917–928

    Google Scholar 

  2. Ben Sira I, Nissenkorn I, Kremer I (1988) Retinopathy of prematurity. Surv Ophthalmol 33(1):1–17

    Google Scholar 

  3. Bossi E, Koerner F, Flury B, Zulauf M (1984) Retinopathy of prematurity: a risk factor analysis with univariate and multivariate statistics. Helv Paediatr Acta 39:307–317

    Google Scholar 

  4. Collaborative European Multicenter Study Group (1988) Surfactant replacement therapy for severe neontal respiratory distress syndrome: an international randomized clinical trial. Pediatrics 82:683–691

    Google Scholar 

  5. Committee for the Classification of Retinopathy of Prematurity (1987) An international classification of retinopathy of prematurity II. The classification of retinal detachment. Arch Ophthalmol 105:906–912

    Google Scholar 

  6. Corbet A, Bucciavelli R, Goldman S, Mammel M, Wold D, Long W, American Exosurf Pediatric Study Group 1 (1991) Decreased mortality rate among small premature infants treated at birth with a single dose of synthetic surfactant: a multicenter controlled trial. J Pediatr 118:277–284

    Google Scholar 

  7. Dunn MS, Shennan AT, Zayack D, Possmayer F (1991) Bovine Surfactant Replacement therapy in neonates of less than 30 weeks gestational age: a randomized controlled trial of prophylaxis versus treatment. Pediatrics 87: 377–386

    Google Scholar 

  8. Fielder A, Shaw D, Robinson J, Ng Y (1992) Natural history of retinopathy of prematurity: a prospective study. Eye 6:233–242

    Google Scholar 

  9. Fujiwara T, Koniskhi M, Chida S, Okuyama K, Ogawa Y, Takeuchi Y, Nishida H, Kito H, Fujimura M, Nakamura H, Hashimoto T (1990) Surfactant replacement therapy with a single postventilatory dose of a reconstituted bovine surfactant in preterm neonates with respiratory distress syndrome: final analysis of a multicenter, double-blind, randomized trial and comparison with similar trials. Pediatrics 86:753–764

    Google Scholar 

  10. Garner A (1990) The role of hyperoxia in the aetiology of retinopathy of prematurity. Doc Ophthalmol 74:187–193

    Google Scholar 

  11. Giedion A, Haefliger H, Dangel P (1973) Acute pulmonary X-ray changes in hyaline membrane disease treated with artificial ventilation and positive and expiratory pressure. Pediatr Radiol 1:145–152

    Google Scholar 

  12. Hennes HM, Lee MB, Rimm AA, Shapiro DL (1991) Surfactant replacement therapy in respiratory distress syndrome. Meta-analysis of clinical trials of single-dose surfactant extracts. Am J Dis Child 145:102–104

    Google Scholar 

  13. Johnson L, Schaffer D, Quinn G, Goldstein D, Mathis MJ, Otis C, Boggs TR Jr (1982) Vitamin E supplementation and the retinopathy of prematurity. Ann NY Acad Sci 393:473–494

    Google Scholar 

  14. Kretzer FL, Hittner HM, Johnson AJ, Mehta RS, Godio LB (1982) Vitamin E and retrolental fibroplasia: ultrastructural support of clinical efficacy. Ann NY Acad Sci 393:145–166

    Google Scholar 

  15. Kretzer FL, Mehta RS, Johnson AT, Hunter DG, Brown ES, Hittner HM (1984) Vitamin E protection against retinopathy of prematurity through action on spindle cells. Nature 309:793–795

    Google Scholar 

  16. Prendiville A, Schulenburg W (1982) Clinical factors associated with retinopathy of prematurity. Arch Dis Child 57:247–252

    Google Scholar 

  17. Rankin SJA, Tubman TRJ, Halliday HL, Johnston SS (1992) Retinopathy of prematurity in surfactant treated infants. Br J Ophthalmol 76:202–204

    Google Scholar 

  18. Repka MX, Hudak ML, Parsa CF, Tielsch JM (1991) Calf lung surfactant extract prophylaxis and retinopathy of prematurity. Ophthalmology 99: 531–536

    Google Scholar 

  19. Seiberth V, Freiwald R, Knorz MC (1991) Risk factors in retinopathy of prematurity: a multivariate statistical analysis. Invest Ophthalmol Vis Sci 33:2343–2344

    Google Scholar 

  20. Sotolongo L, Ferguson O, Yedavally S, Iverson D (1992) A comparison of the incidence and severity of retinopathy of prematurity between age and weight matched infants treated with and without surfactant. Invest Ophthalmol Vis Sci 33:1967–77

    Google Scholar 

  21. Speer CP, Robertson B, Curstedt T, Halliday HL, Compagnone D, Gefeller O, et al (1992) Randomized European multicenter trial of surfactant replacement therapy for severe neonatal respiratory distress syndrome: single versus multiple doses of Curosurf. Pediatrics 89:13–20

    Google Scholar 

  22. Tan KEWP, Cats BP (1989) Timely incidence of retinopathy of prematurity (ROP) and its consequences for the screening strategy. Am J Perinatol 6: 337–340

    Google Scholar 

  23. Tubman TRJ, Rankin SJ, Halliday HL, Johnston SS (1992) Surfactant replacement therapy and the prevalence of acute retinopathy of prematurity. Biol Neonate 61 [Suppl 1]:54–58

    Google Scholar 

  24. Van de Bor M, Ma EJ, Walther FJ (1991) Cerebral blood flow velocity after surfactant instillation in preterm infants. J Pediatr 118:285–287

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Termote, J.U.M., Schalij-Delfos, N.E., Wittebol-Post, D. et al. Surfactant replacement therapy: A new risk factor in developing retinopathy of prematurity?. Eur J Pediatr 153, 113–116 (1994). https://doi.org/10.1007/BF01959221

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01959221

Key words

Navigation