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Retinopathy of prematurity: evaluation of risk factors
B A Brown1, A B Thach, J C Song
1Ophthalmology Service, Walter Reed Army Medical Center, Washington DC, USA.
Insights
Premature infants with lower birth weight and gestational age face higher risks of retinopathy of prematurity (ROP). Factors like oxygen use, ICU stay, and sepsis also contribute to ROP development.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Perinatal Research
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Identifying risk factors is crucial for timely intervention and prevention strategies.
Purpose of the Study:
- To determine key risk factors associated with the development of retinopathy of prematurity (ROP).
- To compare ROP risk factors between singleton and twin infants.
Main Methods:
- Retrospective analysis of 157 infants born between January 1991 and July 1994.
- Evaluation of potential risk factors including gestational age, birth weight, oxygen exposure, ICU stay, steroid use, and sepsis.
- Comparison of ROP incidence and risk factors between singleton and twin gestations.
Main Results:
- 46% of infants developed ROP.
- ROP was associated with lower gestational age, lower birth weight, increased days on oxygen/ventilator, longer ICU stays, steroid use, and sepsis.
- No significant difference in ROP risk factors between singletons and twins, except for longer oxygen therapy duration in singletons.
Conclusions:
- Lower gestational age and birth weight are significant risk factors for ROP, potentially indicating overall illness severity.
- Multiple gestations (twins) do not appear to increase ROP risk compared to singletons when controlling for other factors.
Objectives:
The purpose of this study was to determine what risk factors play a role in the development of retinopathy of prematurity (ROP).
Study Design:
Data were collected on 157 infants born and cared for in one institution between January 1991 and July 1994. Initially we evaluated all children enrolled in the study to determine potential risk factors for the development of ROP. We subsequently compared multiple variables for ROP positive singletons with ROP positive twins to determine ROP risk factors for each group and to determine if one group was more susceptible to a given risk factor.
Results:
Of the 157 infants examined, 72 infants (46%) developed ROP. Infants who developed ROP had a lower gestational age, a lower birth weight, a higher number of days on oxygen/ventilator, more days in the intensive care unit (ICU), a greater need for steroids and a higher incidence of sepsis when compared to infants who did not develop ROP. There was no significant difference noted between singleton and twin gestation infants that developed ROP when comparing gestational age, weight, ventilator time or length of ICU stay. Total number of days on oxygen therapy was higher in the singleton group and this difference did reach statistical significance.
Conclusions:
Several risk factors are associated with a higher incidence of ROP. These variables may not be independent risk factors but may be a sign of the increased severity of illness associated with those infants who are born earlier with a lower birth weight. Multiple gestational births do not appear to increase the risk of developing ROP when compared to a similar group of singleton birth infants.
