High bilirubin levels in neonates may protect against retinopathy of prematurity

Higher levels of bilirubin in preterm neonates may help protect against retinopathy of prematurity (ROP), with increased levels linked to reduced disease severity, according to a study. Researchers suggested that the benefit of prophylaxis phototherapy in premature infants should be reevaluated.

In this case-controlled study, 427 neonates admitted to a NICU for Jaundice evaluation were evaluated for ROP by a fellowship of retina of ophthalmologist at 32 weeks or four weeks after birth.

Overall, 37.7% (n = 121) of patients had a normal eye examination and 62.3% (n = 266) had ROP.

Mean patient characteristics included:

-Weight: 1455.8± 431.4 gram
-Gestational age: 31.6± 2.3 weeks
-Bilirubin: 8.8 ± 2.4 mg / dl

Between controls and neonates with ROP, there were significant differences in the following:

-Birth weight
-Duration of intermittent positive pressure ventilation
-Duration of oxygen therapy
-First and fifth minute Apgar scores
-Maximum level of bilirubin
-Gestational age

In patients with higher stages of ROP, the maximum level of bilirubin was lower.

Reference
Boskabadi H, Shoeibi N, Bagheri F, et al. Potential role of bilirubin in preventing retinopathy of prematurity. Curr Pediatr Rev. 2022 Aug 19. doi: 10.2174/1573396318666220819151154. Epub ahead of print. PMID: 35986544.