{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T11:06:17Z","timestamp":1772535977562,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute for Scientific Research Bento da Rocha Cabral","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Institute for Scientific Research Bento da Rocha Cabral","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Genetics Laboratory, Environmental Health Institute (ISAMB)","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Genetics Laboratory, Environmental Health Institute (ISAMB)","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Associate Laboratory TERRA","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Associate Laboratory TERRA","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Faculty of Medicine of the University of Lisbon","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Faculty of Medicine of the University of Lisbon","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Foundation for Science and Technology","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Foundation for Science and Technology","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"CUF","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"CUF","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Portuguese Society of Ophthalmology","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Portuguese Society of Ophthalmology","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Background\/Objectives: Retinopathy of prematurity (ROP) is a leading cause of vision impairment in preterm infants, with its pathogenesis linked to oxygen exposure. Red blood cell (RBC) transfusions, commonly performed in neonatal intensive care units (NICUs), reduce fetal hemoglobin (HbF) fraction, altering oxygen dynamics and potentially contributing to ROP. We aimed to investigate the relationship between RBC transfusions, HbF percentage, and ROP, evaluating HbF as a potential predictive biomarker. Methods: A multicenter, prospective study was conducted across eight Portuguese NICUs, involving infants born at &lt;32 weeks gestational age (GA) or &lt;1500 g. ROP staging followed the International Classification of ROP (ICROP2). Clinical data were collected during hospitalization, and HbF fractions were measured from blood samples in the first four weeks of life using standardized methods. Infants were stratified by ROP presence and treatment requirement. Statistical analysis was performed using SPSS 28.0, with p &lt; 0.05. Results: Eighty-two infants (mean GA: 28.1 \u00b1 2.1 weeks, birth weight: 1055.8 \u00b1 258.3 g) were included. Among them, 29 (35.4%) presented ROP and 4 (4.9%) required treatment. Infants with ROP had more RBC transfusions and lower HbF percentages than those without ROP (p &lt; 0.05). Lower HbF was associated with more RBC transfusions (p &lt; 0.001). Kaplan\u2013Meier survival curves showed a higher ROP risk in infants with reduced HbF (p &lt; 0.05). Conclusions: Low HbF percentage in the first four weeks of life may increase ROP risk in preterm infants. HbF could serve as a biomarker for ROP prediction. Interventions preserving HbF may reduce ROP risk. Further studies are needed to validate HbF as a biomarker and refine prevention strategies.<\/jats:p>","DOI":"10.3390\/biomedicines13010110","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T04:37:10Z","timestamp":1736138230000},"page":"110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fetal Hemoglobin as a Predictive Biomarker for Retinopathy of Prematurity: A Prospective Multicenter Cohort Study in Portugal"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1875-6581","authenticated-orcid":false,"given":"Mariza","family":"Fevereiro-Martins","sequence":"first","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"},{"name":"Institute for Scientific Research Bento da Rocha Cabral, Cal\u00e7ada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal"},{"name":"Department of Ophthalmology, Cuf Descobertas Hospital, Rua M\u00e1rio Botas, 1998-018 Lisbon, Portugal"}]},{"given":"Laura","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"},{"name":"Institute for Scientific Research Bento da Rocha Cabral, Cal\u00e7ada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0396-6743","authenticated-orcid":false,"given":"\u00c2ngela","family":"In\u00e1cio","sequence":"additional","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"},{"name":"Institute for Scientific Research Bento da Rocha Cabral, Cal\u00e7ada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-7119","authenticated-orcid":false,"given":"Carlos","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Clinical Analysis Laboratory Dr. Joaquim Chaves, Rua An\u00edbal Bettencourt, n\u00ba3, Edificio CORE, 2790-225 Carnaxide, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3688-4648","authenticated-orcid":false,"given":"Ana Carolina","family":"Santos","sequence":"additional","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"}]},{"given":"Carlos","family":"Marques-Neves","sequence":"additional","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"},{"name":"Center for the Study of Vision Sciences, University Ophthalmology Clinic, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, Piso 1C, 1649-028 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6402-3285","authenticated-orcid":false,"given":"Herc\u00edlia","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Pediatrics, Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Rui","family":"Pinto","sequence":"additional","affiliation":[{"name":"Clinical Analysis Laboratory Dr. Joaquim Chaves, Rua An\u00edbal Bettencourt, n\u00ba3, Edificio CORE, 2790-225 Carnaxide, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-5687","authenticated-orcid":false,"given":"Manuel","family":"Bicho","sequence":"additional","affiliation":[{"name":"Ecogenetics and Human Health Unit, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028 Lisbon, Portugal"},{"name":"Institute for Scientific Research Bento da Rocha Cabral, Cal\u00e7ada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1038\/s41390-020-0968-5","article-title":"Predicting the Outcomes of Preterm Neonates beyond the Neonatal Intensive Care Unit: What Are We Missing?","volume":"89","author":"Crilly","year":"2021","journal-title":"Pediatr. Res."},{"key":"ref_2","first-page":"136","article-title":"Critical Analytic Report: Incidence of Retinopathy of Prematurity and Telemedicine for Retinopathy of Prematurity","volume":"40","author":"Ittarat","year":"2023","journal-title":"J. Prapokklao Hosp. Clin. Med. Educ. 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