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Published on: April 2, 2021
[Evaluation of risk factors for retinopathy of prematurity]
Li Zhu1, Wen-Jing Shi, Shu-Lian Zhang
1Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
Insights
Retinopathy of prematurity (ROP) affects 16.4% of preterm infants. Key risk factors include lower birth weight, apnea, and blood transfusions, necessitating targeted interventions.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health Research
Context:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Multicenter studies are crucial for understanding the incidence and risk factors of ROP in diverse populations.
- Early identification and management of ROP are vital for preventing long-term visual consequences.
Purpose:
- To prospectively evaluate the incidence and identify independent risk factors for retinopathy of prematurity (ROP).
- To analyze data from a network of eleven children's and maternal & child hospitals.
- To assess associations between various clinical factors and the development of ROP in very low birth weight infants.
Summary:
- A prospective multicenter study involving 882 preterm infants (<2000g) found an ROP incidence of 16.4% (123 infants).
- Infants with ROP exhibited significantly lower gestational age, birth weight, and longer oxygen duration.
- Independent risk factors identified through logistic regression included lower birth weight, apnea, and blood transfusion.
Impact:
- Identifies critical risk factors for ROP, enabling targeted screening and preventative strategies.
- Provides valuable data for clinical guidelines and resource allocation in neonatal intensive care units.
- Contributes to reducing the burden of visual impairment associated with prematurity.
Objective:
To evaluate the incidence and risk factors of ROP (retinopathy of prematurity) through a prospective multicenter study.
Methods:
Eleven children's or maternal & child hospitals participated in a collective network. All infants of birth weight < 2000 g, born in or transferred to one of the participating centers from January 1st 2005 to February 28th 2006 were recruited. Timely ophthalmologic examinations were performed. The relevant data at baseline and endpoints were collected at each unit.
Results:
A total of 882 preterm infants fulfilled the screening criteria and 752 finished a followup. And 123 infants (16.4%) had some degree of ROP. Infants with ROP had a lower gestational age, birth weight and a longer duration of oxygen versus those without ROP [(30.82 +/- 0.20) weeks vs (32.56 +/- 0.09) weeks, (1430 +/- 25) g vs (1636 +/-10) g, (11.6 +/- 1.4) d vs (4.4 +/- 0.3) d]. Through a univariate analysis, birth weight, gestational age, asphyxia, oxygen duration > 5 days, apnea, surfactant usage, pneumonia, anemia, blood transfusion, acidosis and neonatal respiratory distress syndrome (NRDS) were associated with ROP (P < 0.05). Logistic regression analysis showed that birth weight (OR = 0.998), apnea (OR = 1.653) and blood transfusion (OR = 1.763) were independent risk factors for ROP.
Conclusion:
Asphyxia, oxygen duration > 5 days, surfactant usage, anemia, acidosis and NRDS, lower birth weight, apnea and blood transfusion may improve the risks of ROP.
