349 SYSTEMIC FUNGAL INFECTION IS ASSOCIATED WITH THE DEVELOPMENT OF RETINOPATHY OF PREMATURITY IN EXTREMELY LOW BIRTH WEIGHT INFANTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

BackgroundSystemic fungal infection (SFI) has been shown to be variably associated with retinopathy of prematurity (ROP) and severe ROP in extremely low birth weight infants (ELBWIs).ObjectiveTo study the association between SFI and the development of ROP and severe ROP (stage ≥ 3) in ELBWIs (< 1,000 g) by systematic review and meta-analysis of reported studies.Design/MethodsA comprehensive search of electronic databases, including Medline (1966 to 08/2006), EMBASE (1980 to 3rd Q 2006), and Scopus, using relevant search terms (Candida/albicans/tropicalis/glabrata, candidiasis,”retinopathy of prematurity,” “severe ROP” or “severe retinopathy of prematurity,” retinal detachment, fungemia, “threshold rop,” “threshold retinopathy of prematurity,” “systemic fungal infection,” candidemia, candidiasis, Candida sepsis, “fungal sepsis,” “invasive candidiasis,” “retrolental fibroplasia,” infant, very/extremely low birthweight, “extremely low birth weight,” infant, premature) found seven studies plus an abstract. Authors were contacted for clarification of data from three studies. Raw data of two studies from the same institution were used to avoid duplication as their study periods overlapped. Data were analyzed with Review Manager 4.2 software (Nordic Cochrane Center, Cochrane Collaboration, Købehavn, Denmark). A fixed-effects model was used.ResultsData on infants with any ROP were available from seven studies and for severe ROP from eight studies; 258 of 289 babies with SFI had any ROP compared with 1,043 of 1,479 babies with no SFI, and 117 of 316 with SFI had severe ROP compared with 227 of 1,782 babies with no SFI. ConclusionsSFIs are associated with the development of ROP and severe ROP in ELBWIs. Preventing SFIs may decrease the incidence of ROP in ELBWIs.