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Retinopathy of prematurity: any difference in risk factors between a high and low risk population?
K Allegaert1, I Casteels, V Cossey
1Neonatal Intensive Care Unit, Department of Paediatrics, University Hospitals, Gasthuisberg, Belgium. karel.allegaert@uz.kuleuven.ac.be
Insights
Retinopathy of prematurity (ROP) affects 41% of low birthweight infants. Gestational age is a key risk factor for ROP, especially in the smallest infants, while neonatal severity also plays a role in slightly larger premature babies.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Low birthweight infants are at increased risk for developing ROP.
- Identifying risk factors is crucial for timely intervention and prevention.
Purpose of the Study:
- To determine the incidence of ROP in low birthweight infants (< 1500 g).
- To identify independent risk factors associated with ROP development in different birthweight categories.
Main Methods:
- Retrospective chart review of clinical characteristics in infants categorized by birthweight and Clinical Risk Index for Babies (CRIB) score.
- Statistical analysis including Chi square, Mann-Whitney U tests, and stepwise logistic regression.
Main Results:
- Overall ROP incidence was 41% (76% in < 851 g, 22% in 851-1350 g).
- Gestational age (GA) was a significant risk factor in both birthweight groups.
- Clinical Risk Index for Babies (CRIB) score was an independent risk factor in the 851-1350 g group; maximal creatinemia was also associated in this group.
Conclusions:
- Gestational age is the primary risk factor for ROP in the smallest infants (< 851 g).
- In relatively more mature infants (851-1350 g), both GA and neonatal severity (CRIB score) are important risk factors.
- Maximal creatinemia may be linked to ROP risk, potentially via microangiopathy.
Purpose:
To document incidence of and risk factors for development of retinopathy of prematurity (ROP) in a population of low birthweight infants (< 1500 g).
Methods:
The authors registered clinical characteristics (birthweight, gestational age (GA), Clinical Risk Index for Babies (CRIB), Apgar score, respiratory characteristics (intubation, ventilation, respiratory support, supplemental oxygen, oxygenation index), prescription of dopamine, and maximal creatinemia) by retrospective chart review in two consecutive CRIB score-based (< 851 g, 851-1350 g) categories. Chi square and Mann-Whitney U tests were used to compare clinical characteristics in both categories and a stepwise logistic regression was done to document independent risk factors for either stage 3 (< 851 g) or any grade of ROP (851-1350 g).
Results:
Incidence of ROP was 65/157 (41%; 76% in < 851 g and 22% in 851-1350 g). Incidence of stage 3 ROP was 25/46 (54%) in the < 851 g and 4/84 (5%) in the 851-1350 g group. Among other risk factors, maximal creatinemia was a risk factor in the 851-1350 g cohort (p < 0.03). In a logistic regression model, only GA (OR 0.42) remained significant in the lowest birthweight category; in the 851-1350 g cohort, GA (OR 0.53) and CRIB score (OR 1.7) were independent risk factors for ROP.
Conclusions:
In relatively more mature infants (851-1350 g), the risk to develop ROP is based on GA and on neonatal severity of disease (CRIB score); in the tiniest infants, GA is the most important risk factor. Microangiopathy might explain the association of maximal creatinemia and the risk of developing ROP.
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