Neurodevelopmental outcomes in very low birthweight infants with retinopathy of prematurity in a nationwide cohort study.

In a nationwide prospective cohort of Korean infants with very low birthweights (VLBW, birth weight < 1500 g) from 70 neonatal intensive care units of the Korean Neonatal Network, we investigated neurodevelopmental outcomes in preterm infants with retinopathy of prematurity (ROP) from 2132 infants with VLBW who had undergone developmental assessments at 18-24 months of corrected age. Motor, cognitive, or language delay was determined using developmental scores that were less than 1 standard deviation from the average. Comparative analyses and multivariate regression analyses were performed to validate the association between ROP or its treatment and developmental delay. Motor (52.8% vs. 36.3%), cognitive (46.8% vs. 31.6%), and language delays (42.5% vs. 28.4%) were noted more frequently in infants with ROP than in those without ROP; this was statistically significant (all P < 0.001). Multivariate analyses showed that motor and cognitive delays were significantly associated with ROP. There were no remarkable differences between the neurodevelopmental outcomes and the treatment modalities (laser photocoagulation, anti-vascular endothelial growth factor injection, or both) for ROP, and both stratification and multivariate regression analyses confirmed no significant association between anti-vascular endothelial growth factor therapy and neurodevelopmental delay. As ROP is significantly associated with poor neurodevelopmental outcomes independent of extreme prematurity, neurodevelopmental functions should be given attention in infants with ROP.

Retinopathy of Prematurity and Hearing Impairment in Infants Born with Very-Low-Birth-Weight: Analysis of a Korean Neonatal Network Database.

BACKGROUND: To investigate hearing impairment and its association with retinopathy of prematurity (ROP) among children born with very low birth weight (VLBW, birth weight < 1500 g). METHODS: This prospective registry study included 7940 VLBW infants who underwent both ophthalmic (ROP) and hearing screening at the 70 participating centers of the Korean Neonatal Network. Hearing screening was performed using auditory brainstem response and/or automated otoacoustic emission testing. Hearing impairment, defined as a unilateral or bilateral hearing threshold of ≥40 dB on the auditory brainstem response threshold (ABR-T) test, was evaluated and compared between children with and without ROP at the corrected ages of 18 months and 3 years. RESULTS: The frequency of infants who did not undergo hearing screening at near-term ages was higher in the ROP group than in the no-ROP group (18.2% vs. 12.0%, p < 0.001), and the prevalence of hearing impairment at 18 months was higher in the ROP group than in the no-ROP group (3.5% vs. 2.2%, p = 0.043). The prevalence of deafness was higher in children with ROP than those without ROP (0.4% vs. 0.1%, p = 0.049). There were significant differences in hearing impairment among the stages of ROP (p < 0.001). However, multivariate analyses and propensity score matching showed no significant association between ROP and hearing impairment at 18 months and 3 years after adjusting for prematurity-related variables (all p > 0.05). CONCLUSIONS: Among infants born with VLBW, hearing impairment was more common in those with ROP than in those without ROP at 18 months of age. However, there was no significant independent association between hearing impairment and ROP.

Free radical scavenger effect of rebamipide in sperm processing and cryopreservation.

AIM: To study the effect of rebamipide added to semen samples and cryoprotectant on reactive oxygen species (ROS) production. METHODS: Semen samples from 30 fertile and healthy volunteers were collected by masturbation after 2 days approximately 3 days of abstinence. After liquefaction, the specimens were diluted with sperm wash media to a uniform density of 20 x 10(6)/mL. Rebamipide was added to semen samples and cryoprotectant to a final concentration of 10 micromol/L, 30 micromol/L, 100 micromol/L or 300 micromol/L. Specimens were incubated at 37 degree C in a 0.5 % CO(2) incubator for 1 h or cryopreserved at -196 degree C LN(2) for 3 days. The sperm motility and viability and the levels of ROS and lipid peroxidation of sperm membrance were assessed before and after incubation and cryopreservation by means of computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence and thiobarbituric acid assay, respectively. RESULTS: The sperm motility was significantly increased after incubation with 100 micromol/L and 300 micromol/L rebamipide (P<0.05). After cryopreservation, the sperm motility was significantly decreased in all concentrations (P<0.05), but the decrease was less with 100 micromol/L and 300 micromol/L rebamipide than that with other concentrations. The sperm viability showed no significant difference before and after incubation (P>0.05). The levels of ROS and lipid peroxidation in semen were significantly decreased in proportion to the concentrations of rebamipide both after incubation and cryopreservation (P<0.05). CONCLUSION: Rebamipide is an effective free radical scavenger in semen in vitro.