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[Retinopathy of prematurity screening in Spanish neonatal units]
M T Moral Pumarega1, C R Pallás Alonso, J de la Cruz Bértolo
1Servicio de Neonatología, Hospital Materno-Infantil 12 de Octubre, Madrid, España. maitemoral@hotmail.com
Insights
Spanish hospitals screen all premature infants for retinopathy of prematurity (ROP). However, there is significant variation in screening criteria and protocols, highlighting a need for standardized ROP screening guidelines.
Area of Science:
- Neonatal ophthalmology
- Public health
- Pediatric screening protocols
Context:
- Retinopathy of prematurity (ROP) screening lacks standardized criteria across Spanish hospitals.
- Previous studies demonstrated cryotherapy benefits for severe ROP, leading to recommendations by scientific societies.
- No specific national guidelines exist within the Spanish scientific community for ROP screening, diagnosis, or treatment.
Purpose:
- To survey and describe the current retinopathy of prematurity screening criteria used in Spanish hospitals.
- To assess the adherence to established protocols and identify variations in ROP screening practices among neonatal units.
Summary:
- A cross-sectional study surveyed 50-questionnaires sent to Spanish neonatal units caring for infants <1500g birth weight.
- All surveyed hospitals perform ROP screening, but only 62.9% follow a written protocol.
- Key screening criteria include birth weight (<1500g), gestational age (32 weeks), and oxygen supplementation, though practices vary significantly.
Impact:
- Highlights a critical lack of consensus in ROP screening practices across Spain.
- Suggests a need for the development and implementation of standardized ROP screening protocols nationwide.
- Identifies opportunities for improving the consistency and effectiveness of ROP screening in premature infants.
Introduction:
A wide variety of retinopathy of prematurity (ROP) screening criteria exists in the different hospitals. In 1988, the benefits of cryotherapy treatment in severe ROP cases were demonstrated, and since then, some scientific societies have made recommendations on the screening and treatment of ROP. Within the Spanish scientific community, there are no specific recommendations on screening, diagnosis or treatment.
Objectives:
To describe the criteria used in the screening of retinopathy in premature newborns by those Spanish hospitals caring for babies with birth weights below 1,500 g.
Material And Method:
A cross-sectional study was performed based on a 50 question questionnaire on screening criteria and other related issues. This questionnaire was sent to those public and private neonatal units in Spain caring for babies with birth weights below 1,500 grams. The questionnaire was sent and returned between January 2002 and May 2003.
Results:
Units in all of the 17 autonomous communities and both autonomous cities in territorial Spain (Ceuta and Melilla) responded. There was a 90% response rate. All the participating hospitals perform ROP screening. Only 62.9% of the hospitals follow a written protocol on screening. A large majority of hospitals (79.8%) perform a retinal eye examination on all newborns below 1500 g at birth. Half of the hospitals included in the study, 51.6%, determine the cut-off point for performing the screening at 32 weeks of gestational age. Around 73% of the hospitals include the administering of oxygen supplements to premature babies as part of the criteria for screening, regardless of the babies' weight and gestational age. Weight, gestational age and oxygen are the only criteria used in 51% of the units. That all hospitals in Spain should establish some screening criteria was suggested by 90% of the responses. Only 10% use analgesia or sedation, other than topical, when examining the retina.
Conclusions:
Even though all the hospitals participating in the study screen for ROP, there is little agreement on which criteria should be followed when screening and on other aspects related to its practice.
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