Postnatal Serum Insulin-Like Growth Factor I and Retinopathy of Prematurity in Latin American Infants

ABSTRACT

Purpose

Identifying at-risk infants for retinopathy of prematurity (ROP) is complex in countries with emerging economies as infants that lack conventional risk factors, such as low birth weight (BW) and young gestational age (GA), still go on to develop severe ROP. Potential biomarkers, like serum insulin-like growth factor 1 (IGF-1) and slow postnatal weight gain, have been identified as good predictors for ROP in developed countries. We sought to determine the relationship between IGF-1 levels and ROP in two Latin American countries where the burden of disease is still significant.

Methods

Prospective cohort study of infants in Guadalajara, Mexico and La Plata, Argentina. Filter-paper bloodspot IGF-1 assays were performed weekly from birth until hospital discharge or 40 weeks’ postmenstrual age (PMA).

Results

112 infants were studied with a median BW of 1412 g (range 620 g-2390 g) and a median GA of 33 weeks (range 25–37). There was no significant difference in IGF-1 between infants who developed ROP and those who did not.

Conclusion

Low IGF-1 was not associated with ROP in these infants. The lack of an association between ROP and IGF-1 in Latin America supports the observation that growth-based predictive models do not perform as well in this setting where more mature babies still develop severe ROP.

KEYWORDS:

• Insulin-like growth factor 1
• prematurity
• retinopathy of prematurity

Conflicts of interest

None of the authors have any proprietary interests or conflicts of interest related to this submission.

Brief summary statement

Subsequent development of ROP in Latin American infants was not found to be associated with low serum insulin-like growth factor 1. Excessive oxygen supplementation likely plays a more dominant role in the pathogenesis of ROP in these infants.

Additional information

Funding

Supported in part by the National Institute of Health, NIH grants [K12 EY015398, L30 EY018451-03, 2-P30-EY01583-26, UL1-RR-024134], and the Bayer-Global Ophthalmology Award Program, the Pan-American Ophthalmological Foundation, and the Richard Shafritz Chair in Ophthalmology Research.