The Role of Acute Phase Reactants, Including α1-Acid Glycoprotein, in Predicting Onset and Severity of Retinopathy of Prematurity

TL;DR

This study shows that α1-acid glycoprotein can help predict the onset and severity of retinopathy of prematurity in premature infants.

Contribution

The study introduces α1-acid glycoprotein as a novel acute phase reactant for predicting retinopathy of prematurity.

Findings

α1AG was the best predictor of ROP onset and progression up to 30 weeks CGA.

Adding α1AG to conventional models improved prediction accuracy by 4–5%.

APR incorporation helps determine treatment necessity by 30 weeks CGA.

Abstract

Background: Retinopathy of prematurity (ROP) is a serious disease causing blindness in childhood. Gestational age (GA) and birth weight are major factors associated with the development and progression of ROP, but postnatal systemic inflammation is also an important well-known risk factor. Methods: This study retrospectively analyzed the relationship between systemic inflammation and ROP severity using the corrected GA (CGA), which reflects the intrinsic immaturity of the infant, rather than days of life. Three acute phase reactants (APRs) were analyzed using discriminant probability and compared with conventional ROP prediction models: C-reactive protein, α1AG, and haptoglobin. Results: Alpha 1AG was the best predictor of ROP onset and progression, and could be predicted with blood samples up to 30 weeks (30 W) CGA (p = 0.006). Incorporation of APR into the conventional GA + body weight (BW), ROP score, and Children’s Hospital of Philadelphia (CHOP) predictive models improved the decision to treat (4–5% increase in discrimination probability) and helped determine whether treatment of ROP was necessary by CGA 30 W. Conclusions: Therefore, simply adding α1AG protein to the assessment is useful for predicting the need to treat ROP.