Longitudinal postnatal weight and insulin-like growth factor I measurements in the prediction of retinopathy of prematurity

Arch Ophthalmol. 2006 Dec;124(12):1711-8. doi: 10.1001/archopht.124.12.1711.


Objective: To investigate whether postnatal growth and development influence retinopathy of prematurity (ROP) and may be included in screening for ROP.

Design: We developed an algorithm to predict for individual infants the risk of later ROP development requiring treatment based on the postnatal longitudinal systemic factors of insulin-like growth factor I (IGF-I) level, IGF binding protein 3 level, and postnatal weight gain. We developed the algorithm based on 79 preterm infants considered at risk for ROP by standard criteria (gestational age, 23.6-31.7 weeks) in a longitudinal study measuring weight gain and serum IGF-I and IGF binding protein 3 levels weekly from birth until discharge from the hospital. We monitored deviations from reference models for weight and IGF-I level (preterm children who developed no or minimal ROP) to detect indications for treatable ROP by Early Treatment for Retinopathy of Prematurity study criteria.

Results: This monitoring method detected 6 (100%) of 6 infants in this cohort who required treatment for ROP with a warning signal at least 5 weeks before requiring treatment and at least 3 weeks before the onset of stage 3 ROP. The majority of infants (61/73 infants) requiring no treatment were also correctly identified.

Conclusions: Monitoring the postnatal factors of weight, IGF-I level, and IGF binding protein 3 level substantially enhances the clinician's ability to identify patients who will require treatment for ROP.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Biomarkers / blood*
  • Birth Weight / physiology*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature / blood*
  • Insulin-Like Growth Factor Binding Protein 3
  • Insulin-Like Growth Factor Binding Proteins / blood*
  • Insulin-Like Growth Factor I / analysis*
  • Male
  • Radioimmunoassay
  • Reference Values
  • Retinopathy of Prematurity / blood*
  • Retinopathy of Prematurity / etiology
  • Retinopathy of Prematurity / therapy
  • Risk Factors
  • Weight Gain / physiology*


  • Biomarkers
  • IGFBP3 protein, human
  • Insulin-Like Growth Factor Binding Protein 3
  • Insulin-Like Growth Factor Binding Proteins
  • Insulin-Like Growth Factor I