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. 2025 Jan;263(1):69-76.
doi: 10.1007/s00417-024-06604-9. Epub 2024 Aug 22.

The relationship between inflammatory markers and retinopathy of prematurity in extremely premature infants

Fatma Merve Bektaş  1 , Emin Serbülent Güçlü  2 , Hüseyin Şimşek  3 , Mustafa Akçali  3
Affiliations

The relationship between inflammatory markers and retinopathy of prematurity in extremely premature infants

Fatma Merve Bektaş et al. Graefes Arch Clin Exp Ophthalmol. 2025 Jan.

Abstract

Purpose: This study aimed to evaluate the relationships among blood parameters, clinical factors, and retinopathy of prematurity (ROP) in extremely premature (EP) infants.

Methods: This retrospective study included 153 EP infants who were categorized into two groups based on the presence of inflammatory diseases such as necrotizing enterocolitis, neonatal sepsis, bronchopulmonary dysplasia, severe intraventricular hemorrhage, preeclampsia, and premature rupture of membranes. Complete blood count parameters, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, platelet-lymphocyte ratio (PLR), systemic inflammatory index, and platelet mass index were recorded during the first week and first month after birth. The study analyzed the impact of parameters obtained through blood tests during the first week and first month on the development of ROP and the requirement for treatment.

Results: In this study, 96 infants were diagnosed with inflammatory diseases. After multivariate regression analyses, the duration of mechanical ventilation (p = 0.010) was found to be the only factor that led to ROP development. Moreover, lower gestational age (GA) (p = 0.006), higher NLR (p = 0.026), and lower PLR (p = 0.019) were observed in infants requiring treatment compared to infants with spontaneous resolution of ROP in this group. 57 infants did not have inflammatory diseases. Although the duration of mechanical ventilation (p = 0.041) and low levels of platelets (PLT) (p = 0.046) measured in the first month postnatally were significantly found to be associated with ROP developement, no parameter affecting the required treatment could be determined.

Conclusion: EP infants with longer mechanical ventilation durations and lower PLT counts are vulnerable to ROP development. GA, PLR, and NLR are predictive factors for treatment.

Keywords: Complete blood count; Extreme prematurity; Inflammation; Retinopathy of prematurity.

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Conflict of interest statement

Declarations. Ethical approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the Mersin University Faculty of Medicine Ethics Committee on 18.10.2023 with protocol number 2023/698 and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript. Informed consent: Informed consent was obtained from all individual participants included in the study.

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