Infantile Hemangiomas and Retinopathy of Prematurity: Possible Association

OBJECTIVE. The goal was to study the clinical association between infantile hemangiomas and retinopathy of prematurity in preterm infants. METHODS. A retrospective study of preterm neonates weighing ≤1250 g at birth who were born during a 5-year period (November 1, 2000, to October 31, 2005) at John Dempsey Hospital was performed by using a prospectively collected, neonatal database. Data were collected on demographic features (gestational age, birth weight, and gender) and prenatal/postnatal steroid use. In the physical examination at discharge, all infants were checked for infantile hemangiomas, and the size and number of lesions were noted. The highest stage of retinopathy of prematurity diagnosed at any time before discharge also was noted. Analyses were performed to identify associated risk factors. RESULTS. Of 406 neonates admitted with birth weights of ≤1250 g, 351 (86.4%) survived. Of the survivors, 49 (13.9%) had infantile hemangiomas at discharge. Infantile hemangiomas were present for 16.8% of neonates with retinopathy of prematurity, compared with 6.7% of those without retinopathy of prematurity. Multiple infantile hemangiomas were present in 14 (28.5%) of 49 neonates, whereas 18 (42.8%) of 42 neonates had infantile hemangiomas that were ≥1 cm in size. Univariate analyses showed lower gestational age, lower birth weight, and postnatal steroid use to be predictors of retinopathy of prematurity, whereas prenatal steroid use, race, and gender were not significantly related. In multivariate logistic regression analyses controlling for gestational age and postnatal steroid use, infantile hemangiomas were found to be independently associated with any stage of retinopathy of prematurity. Neither the number nor the size of infantile hemangiomas showed any association with the severity of retinopathy of prematurity. CONCLUSIONS. Infantile hemangiomas are associated with the development of retinopathy of prematurity in infants weighing ≤1250 g. The biological significance of this association may yield clues to the management of retinopathy of prematurity.