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Risk factors for severe retinopathy of prematurity in premature infants: a single-center study
Xiao-yun Ke1, Rui-hong Ju, Jia-qing Zhang
1Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China. keyan96612@163.com
Insights
Severe retinopathy of prematurity (ROP) affects nearly 9% of preterm infants, with lower gestational age and retinal hemorrhage being key risk factors. This study highlights independent predictors for severe ROP, aiding in early identification and intervention strategies.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Public health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Understanding the incidence and risk factors for severe ROP is crucial for effective management and prevention strategies.
- Previous studies have identified various risk factors, but ongoing research is needed to refine predictive models.
Purpose of the Study:
- To determine the incidence of severe retinopathy of prematurity (ROP) in a cohort of preterm infants.
- To identify significant risk factors associated with the development of severe ROP.
- To establish independent predictive factors for severe ROP in this population.
Main Methods:
- A retrospective analysis of 957 preterm infants screened for ROP between May 2008 and May 2011.
- Infants underwent retinal evaluation using RetCamII at 4-6 weeks chronological age or 32 weeks postmenstrual age.
- Statistical analysis was performed to identify significant variables and independent risk factors for severe ROP.
Main Results:
- The overall incidence of ROP was 8.99%, with 2.72% of infants developing severe ROP.
- Infants with severe ROP had significantly lower gestational age (29.88 weeks) and birth weight (1420.40 g) compared to those with mild ROP.
- Independent risk factors for severe ROP included lower gestational age and the presence of retinal hemorrhage.
Conclusions:
- Severe ROP incidence appears to be decreasing and affects more mature preterm infants.
- Gestational age and retinal hemorrhage are confirmed as independent predictive factors for severe ROP.
- Findings suggest a need for targeted screening and intervention based on identified risk factors.
Objective:
To evaluate the incidence and risk factors for severe retinopathy of prematurity (ROP) in preterm infants.
Methods:
Between May, 2008 and May, 2011, a total of 957 preterm infants at 4-6 weeks of chronological age or 32 weeks of postmenstrual age underwent retinal evaluation by RetCamII in our center, and the data of infants with ROP in any stage were analyzed.
Results:
Among the 957 preterm infants, we found 86 (8.99%) infants to have ROP in different stages, including 60 (6.27%) with mild ROP and 26 (2.72%) with severe ROP. The birth weight and gestational age of the infants with severe ROP averaged 1 420.40∓328.64 g and 29.88∓1.67 weeks, as compared to 1 593.28∓339.30 g and 31.78∓2.53 weeks in those with mild ROP, respectively, showing a significant difference between the two groups (P<0.005). The significant variables for severe ROP included gestational age (P=0.001), birth weight (P=0.035), 1 min Apgar score (P=0.001), 5 min Apgar score (P=0.005), number of blood transfusions (P=0.032), and the presence of apnea (P=0.04) and retinal hemorrhage (P=0.000). Gestational age and retinal hemorrhage were the independent risk factors for severe ROP (OR=0.353, 95%CI 0.163-0.763, P=0.008; OR=26.133, 95%CI 3.042-224.501, P=0.035).
Conclusion:
Severe ROP tends to have a decreasing incidence and occurs more often in more mature preterm infants. The affected infants have the characteristics of the first epidemics. Gestational age and retinal hemorrhage are independent predictive factors for severe ROP.
