Fetal hemoglobin in the development and progression of retinopathy of prematurity in preterm infants: Comment

Dear Editor,

We would like to comment on the study “Role of fetal hemoglobin in the development and progression of retinopathy of prematurity in preterm infants”.[1] The purpose of this study was to look into the connection between preterm infants’ retinopathy of prematurity (ROP) and their levels of fetal hemoglobin (HbF). A dilated fundus examination was performed for ROP staging on 410 preterm infants with a birth weight of less than 2.5 kg and a gestational week of less than 36, who were included in the study. High-performance liquid chromatography was used to measure and statistically analyze the HbF levels. The findings demonstrated that, in comparison to infants without ROP, infants with ROP had significantly lower HbF levels. A lower prevalence of ROP was linked to higher HbF levels. Higher HbF levels were seen in ROP infants who regressed naturally without medical intervention, whereas lower concentrations were seen in the infants who developed a severe illness and needed medical attention.

There are a few restrictions to take into account, though. First off, since the study was observational, it is impossible to prove causation. Furthermore, the study’s findings cannot be applied to other populations because it was only carried out in one tertiary care hospital in central India. The study only lasted 1 year and the sample size was quite small, so it is possible that it did not cover the full range of ROP outcomes. Furthermore, the study only assessed HbF levels at two intervals – the first visit and at a 1-month follow-up – so it was not possible to fully evaluate how the HbF levels changed over time. Furthermore, oxygen exposure and other genetic and environmental factors are examples of potential factors that may influence the development of ROP, but these were not evaluated in this study. In addition, in areas with a high incidence of thalassemia, background abnormal HbF is possible and it is difficult to apply HbF in this specific situation.

Further research is required to confirm these results and evaluate the relationship between HbF levels and ROP in a variety of populations. This will involve conducting larger multicenter studies with longer follow-up periods. A more thorough examination of HbF’s correlation with ROP would be possible through longitudinal studies that assess the levels of the protein at various points over time. Additional research ought to look into other possible causes and processes connected to the onset of ROP.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.