1722· Clinical Research ·A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levelsYe?im Co?kun 1 , Ceyhun Dalkan 2 , Özge Yaba? 3 , Özlem Ünay Demirel 4 , Elif Samiye Bayar 5 , Sibel Sakarya 5 , Tuba Müftüo?lu 6 , Dilaver Er?anl? 7 , Nerin Bahçeciler 8 , ?pek Akman 1,21 Department of Pediatrics, Bahce?ehir University Medical Faculty, Medical Park Goztepe Hospital, Istanbul 34732, Turkey 2 Department of Pediatrics, Division of Neonatology, Near East University, Nicosia 99138, North Cyprus3 Department of Ophtalmotology, Bahce?ehir University Medical Faculty, Medical Park Goztepe Hospital, Istanbul 34732, Turkey4 Department of Biochemistry, Bahce?ehir University Medical Faculty, Medical Park Goztepe Hospital, Istanbul 34732, Turkey5 Department of Public Health, Marmara University Medical Faculty, Istanbul 34890, Turkey6 Department of Biochemistry, GATA Haydarpa?a Hospital, Istanbul 34668, Turkey7 Department of Ophtalmotology, GATA Haydarpa?a Hospital, Istanbul 34668, Turkey8 Department of Pediatrics, Near East University, Nicosia 99138, North CyprusCorrespondence to: Ye?im Co?kun. Bahce?ehir University Medical Faculty, Department of Pediatrics, Medical Park Goztepe Hospital, Istanbul 34732, Turkey. coskunyesim@yahoo.com Received: 2016-10-11 Accepted: 2017-07-10Abstract● AIM: To detect the impact of insulin-like growth factor-1 (IGF-1) and other risk factors for the early prediction of retinopathy of prematurity (ROP) and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.● METHODS: The study was conducted with 127 preterm infants. IGF-1 levels in the 1 st day of life, 1 st , 2 nd , 3 rd and 4 th week of life was analyzed. The score was established after logistic regression analysis, considering the impact of each variable on the occurrences of any stage ROP. A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.● RESULTS: Birth weights (BW), gestational weeks (GW) and the prevalence of breast milk consumption were lower, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) and necrotizing enterocolitis (NEC) were more frequent, the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP (P<0.05). Initial serum IGF-1 levels tended to be lower in newborns who developed ROP. Logistic regression analysis revealed that low BW (<1250 g), presence of intraventricular hemorrhage (IVH) and formula feeding increased the risk of ROP. Afterwards, the scoring system was validated on 107 infants. The negative predictive values of a score less than 4 were 84.3%, 74.7% and 79.8% while positive predictive values were 76.3%, 65.5% and 71.6% respectively.● CONCLUSION: In addition to BW <1250 g and IVH, formula consumption was detected as a risk factor for the development of ROP. Breastfeeding is important for prevention of ROP in preterm infants.● KEYWORDS: retinopaty of prematurity; insulin-like growth factor-1; breast milk; protectivityDOI:10.18240/ijo.2017.11.14Citation: Co?kun Y, Dalkan C, Yaba? Ö, Demirel ÖÜ, Bayar ES, Sakarya S, Müftüo?lu T, Er?anl? D, Bahçeciler N, Akman ?. A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levels. Int J Ophthalmol 2017;10(11):1722-1727INTRODUCTION Retinopathy of prematurity (ROP) is a clinically multifactorial process that can cause blindness in preterm infants. The prevalence of ROP ranges from 0-30%, depending on the quality of neonatal care and the set of individual risk factors [1-2] . Several risk factors have been reported as involved in the development of ROP but birth weight (BW) and gesta-tional age (GA) are considered the most important risk factors for disease onset [3] . Therefore many ROP screening protocols are based on BW and GA. American Academia of Pediatrics (AAP) recommends screening for babies with BW ≤1500 g and GA ≤30wk. Also the infants whose BW is 1500-2000 g but having an unstable clinical course or requiring respiratory support are recommended to undergo ocular examination for ROP score, IGF-1 and protective effect of breastfeedingPublished online：2017-11-08 09:54:24URL：http://kns.cnki.net/kcms/detail/CN.20171108.0954.028.html
