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Incidence and risk factors for retinopathy of prematurity in a Brazilian reference service
Eduardo Gonçalves1, Luciano Sólia Násser2, Daniella Reis Martelli2
1Faculdades Integradas Pitágoras, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil.
Insights
Retinopathy of prematurity (ROP) incidence was high at 44.5% in extremely premature infants. Key risk factors included low birth weight, early gestational age, blood product use, and sepsis.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of preventable blindness in premature infants.
- Early diagnosis and intervention are crucial for preventing severe visual impairment in affected children.
- Understanding ROP incidence and associated risk factors is vital for targeted prevention strategies.
Purpose of the Study:
- To determine the incidence of Retinopathy of prematurity (ROP) in a neonatal intensive care unit (NICU) population.
- To identify and analyze the association between known risk factors and the development of ROP.
Main Methods:
- A longitudinal incidence study was conducted in the NICU of Universidade Estadual de Montes Claros.
- Infants with gestational age < 32 weeks and/or birth weight < 1,500 grams were followed for two years.
- ROP assessment followed a national protocol; statistical analyses included chi-square, Fisher's exact test, and logistic regression.
Main Results:
- The overall incidence of ROP was 44.5% (95% CI: 35.6-46.1).
- Significant risk factors for ROP included birth weight < 1,000 grams (OR=4.14), gestational age < 30 weeks (OR=6.69), use of blood derivatives (OR=4.14), and sepsis (OR=1.99).
- Extreme prematurity was strongly associated with an increased risk of developing ROP.
Conclusions:
- The observed incidence of ROP in this study population exceeds previously reported figures.
- Extreme prematurity, indicated by low birth weight and early gestational age, emerged as the primary risk factor for ROP.
- Findings underscore the need for vigilant screening and management of ROP in high-risk premature infants.
Context And Objective:
Retinopathy of prematurity (ROP) is a known cause of blindness in which diagnosis and timely treatment can prevent serious harm to the child. This study aimed to evaluate the incidence of ROP and its association with known risk factors.
Design And Setting:
Longitudinal incidence study in the neonatal intensive care unit (NICU) of Universidade Estadual de Montes Claros.
Methods:
Newborns admitted to the NICU with gestational age less than 32 weeks and/or birth weight less than 1,500 grams, were followed up over a two-year period. The assessment and diagnosis of ROP were defined in accordance with a national protocol. The chi-square test or Fisher's exact test were used to determine associations between independent variables and ROP. Analysis on the independent effect of the variables on the results was performed using multiple logistic regression.
Results:
The incidence of ROP was 44.5% (95% confidence interval, CI = 35.6-46.1) in the study population. The risk factors associated with the risk of developing the disease were: birth weight less than 1,000 grams (odds ratio, OR = 4.14; 95% CI = 1.34-12.77); gestational age less than 30 weeks (OR = 6.69; 95% CI = 2.10-21.31); use of blood derivatives (OR = 4.14; 95% CI = 2.99-8.99); and presence of sepsis (OR = 1.99; 95% CI = 1.45-2.40).
Conclusions:
The incidence of ROP was higher than that found in the literature. The main risk factors were related to extreme prematurity.
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