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Retinopathy of prematurity in extremely low birth weight infants in Malaysia
May May Choo1, Frank Joseph Martin, Lim Chin Theam
1Department of Ophthalmology, University of Malaya, Kuala Lumpur, Malaysia. mmchoo@um.edu.my
Insights
Extremely low birth weight infants born in Malaysia with birth weights under 750g had double the likelihood of requiring treatment for retinopathy of prematurity (ROP). This finding highlights the importance of monitoring ROP in this vulnerable population.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Extremely low birth weight (ELBW) infants are at a higher risk for developing ROP.
- Understanding risk factors and outcomes in specific populations is crucial for effective management.
Purpose of the Study:
- To compare the incidence, risk factors, and outcomes of ROP between two birth weight categories of ELBW infants in Malaysia.
- To identify specific risk factors associated with the need for laser treatment for ROP in this cohort.
- To assess differences in ROP severity based on birth weight.
Main Methods:
- Prospective study conducted at the University of Malaya Medical Centre from 2003-2005.
- Inclusion of ELBW infants, with outcome measures including ROP presence, severity, and laser treatment.
- Analysis of risk factors for treatment in infants categorized by birth weight (<751 g vs. 751-1,000 g).
Main Results:
- Of 70 ELBW infants, 58.6% developed ROP and 32.9% required laser treatment.
- Infants with birth weight <750 g were twice as likely to require treatment (OR = 2).
- Key risk factors for treatment included gestation <28 weeks, prolonged ventilation, and intraventricular hemorrhage.
Conclusions:
- The incidence of ROP in Malaysian ELBW infants is comparable to international studies.
- Lower birth weight (<750 g) significantly increases the likelihood of ROP requiring treatment.
- Gestational age, ventilation duration, and intraventricular hemorrhage are critical risk factors for ROP treatment in ELBW infants.
Purpose:
To identify differences in incidence, risk factors, and outcomes of retinopathy of prematurity (ROP) between 2 birth weight categories within a cohort of extremely low birth weight (ELBW) infants in Malaysia.
Methods:
This was a prospective study of infants in the Special Care Nursery at the University of Malaya Medical Centre between 2003 and 2005. Outcome measures were presence or absence of ROP, most severe stage of ROP observed, and whether laser treatment was performed. Risk factors for treatment were analyzed in this cohort of treated patients, who were further divided into groups of birth weight <751 g and birth weight 751-1,000 g.
Results:
The study protocol identified 70 qualifying ELBW infants. Of these, 41 (58.6%) developed ROP and 23 (32.9%) required laser treatment. Mean birth weight was 806.8 g (SD +/- 142.5); mean gestation was 27.4 weeks (SD +/- 2.2). Infants with birth weight <750 g were twice as likely to require treatment (OR = 2, p = 0.038). The risk factors for laser treatment by bivariate analysis were gestation <28 weeks (OR = 1.8, p = 0.001), duration of ventilation >1 week (OR = 1.5, p = 0.012), and intraventricular hemorrhage (OR = 2.5, p = 0.010). Zone 1 ROP was observed only in infants <751 g.
Conclusions:
The incidence of ROP in ELBW infants in Malaysia is comparable to that seen in the ETROP and CRYO-ROP studies. Within this group, birth weight <750 g doubled the likelihood that treatment would be required.
