Background and aims Retinopathy of Prematurity (ROP) is an important cause of visual impairment and blindness in children.1
Aim Conduct a systematic review and meta-analysis to determine the association between blood transfusion and the development of ROP in preterm infants ≤32 weeks gestational age or birthweight <1500 grams.
Data Sources: MEDLINE, EMBASE, Cochrane Register, CINAHL, LILACS, Web of Knowledge, clinicaltrial.gov and Open SIGLE.
Study Selection Criteria: Cohort and case-control studies from 2000 onwards: Four reviewers independently assessed eligibility.
Data Extraction and analysis: The outcome measure was ‘all stages of ROP’. Quality assessment of studies was done using Newcastle-Ottawa scale. A random effects meta-analysis model was used and heterogeneity was assessed using I2 statistic.
Results Nine studies met the final selection criteria. Total sample size was 2106 preterm infants with median gestational age 30 weeks and birth weight 1228 grams. Blood transfusion was associated with the development of ROP; unadjusted odds ratio (OR) = 3.05 (95% CI 2.16 to 4.32) with a significant heterogeneity (I2 = 54.8% p = 0.02). The unadjusted pooled OR in three of these studies was 2.59 (95% CI 1.35 to 4.98) and the adjusted pooled OR was 1.18 (95% CI 0.96 to 1.33), I2 = 8.8%.
Conclusion Blood transfusion was associated with the development of ROP in preterm infants. However once other factors such as gestational age and birth weight were adjusted for, the association between blood transfusion and ROP development was considerably weaker.
Gilbert et al. Eye (Lond) 2007;21:1338–43
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