Evidence map›Paper›PMID 37291231›Full record

ArticlePediatric research2023

Impact of postnatal steroids on peripheral avascular retina and severity of retinopathy of prematurity.

Prem S Shekhawat, Mahmoud A M Ali, Naveen Kannekanti, Hannah Koechley, Christiane Mhanna, Merlin Pinto, Mohsen A A Farghaly, Maroun Mhanna, Hany Z Aly, Jonathan E Sears

Abstract read
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In one paragraph

Article in Pediatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Prem S ShekhawatDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA. pshekhawat@metrohealth.org.ORCID 0000-0002-6080-4321
Mahmoud A M AliDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Naveen KannekantiDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Hannah KoechleyDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Christiane MhannaDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Merlin PintoDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Mohsen A A FarghalyDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Maroun MhannaDepartment of Pediatrics, Division of Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, 44109, USA.
Hany Z AlyDepartment of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, 44106, USA.
Jonathan E SearsCole Eye Institute, The Cleveland Clinic, Cleveland, OH, 44106, USA.
MetroHealth Medical Center · USCleveland Clinic · USWright State University · US

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
NCATS NIH HHS UL1 TR002548
6 · The paper itself

Abstract

backgroundWe investigated the role of postnatal steroids on the severity of retinopathy of prematurity (ROP) and its impact on peripheral avascular retina (PAR).

methodsA retrospective cohort study of infants born at ≤32 weeks gestation and/or birth weight ≤1500 g. Demographics, the dose and duration of steroid treatment, and age when full retinal vascularization occurred were collected. The primary outcomes were the severity of ROP and time to full vascularization of the retina.

resultsA total of 1695 patients were enrolled, 67% of whom received steroid therapy. Their birth weight was 1142 ± 396 g and gestational age was 28.6 ± 2.7 weeks. The total hydrocortisone-equivalent dose prescribed was 28.5 ± 74.3 mg/kg. The total days of steroid treatment were 8.9 ± 35.1 days. After correction for major demographic differences, infants who received a higher cumulative dose of steroids for a longer duration had a significantly increased incidence of severe ROP and PAR (P < 0.001). For each day of steroid treatment, there was a 3.2% increase in the hazard of the severe form of ROP (95% CI: 1.022-1.043) along with 5.7% delay in achieving full retinal vascularization (95% CI: 1.04-1.08) (P < 0.001).

conclusionCumulative dose and duration of postnatal steroid use were independently associated with the severity of ROP and PAR. Thus, postnatal steroids should be used very prudently. IMPACT: We report ROP outcomes in a large cohort of infants from two major healthcare systems where we have studied the impact of postnatal steroids on the severity of ROP, growth, and development of retinal vessels. After correcting our data for three major outcome measures, we show that high-dose postnatal steroids used for a prolonged duration of time are independently associated with severe ROP and delay in retinal vascularization. Postnatal steroids impact the visual outcomes of VLBW infants significantly, so their clinical use needs to be moderated.

Indexed as

Retinal NeovascularizationRetinopathy of PrematurityBirth WeightGestational AgeHumansInfantInfant, NewbornRetinaRetrospective StudiesRisk FactorsSteroidsSteroids

Identifiers

PMID37291231
OpenAlexW4379882863

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.