Retinopathy of prematurity risk prediction for infants with birth weight less than 1251 grams
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Published on: April 2, 2021
Alex R Kemper1, Kelly C Wade2, Christoph P Hornik1
1Duke Clinical Research Institute, Durham, NC.
Insights
Predicting retinopathy of prematurity (ROP) in premature infants is possible using previous exam findings, gestational age (GA), and postmenstrual age (PMA). This aids in resource allocation and family communication for neonatal intensive care units.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Medical predictive modeling
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Accurate prediction of ROP progression is crucial for timely intervention and resource management in neonatal intensive care units (NICUs).
Purpose of the Study:
- To develop a predictive model for retinopathy of prematurity (ROP) exam findings in premature infants.
- To identify key factors influencing ROP development and retinal maturation.
Main Methods:
- Secondary analysis of 3714 eye exams from 1239 infants with birth weight less than 1251 g.
- Utilized gestational age (GA) and postmenstrual age (PMA) to assess ROP likelihood.
- Evaluated previous exam findings, GA, and PMA as predictors for type 1 ROP and mature retina.
Main Results:
- The likelihood of developing type 1 ROP by 40 weeks PMA varied significantly with gestational age (GA), ranging from 33% for GA ≤25 weeks to 0% for GA ≥30 weeks.
- At 40 weeks PMA, 51% of infants with GA ≤27 weeks still required further eye examinations.
- Previous exam findings, GA, and PMA were significant predictors of type 1 ROP (AUC=0.78) and mature retina (AUC=0.85).
Conclusions:
- Gestational age and postmenstrual age are critical factors in predicting ROP outcomes.
- A predictive model incorporating previous exam findings, GA, and PMA can effectively estimate ROP progression and retinal maturation.
- This approach can optimize resource allocation in NICUs and improve communication with families regarding infant care and discharge planning.
Objective:
To predict retinopathy of prematurity (ROP) exam findings among infants with birth weight <1251 g from 32-40 weeks postmenstrual age (PMA).
Study Design:
Secondary analysis of 3714 eye exams from 1239 infants.
Results:
The likelihood of developing type 1 ROP by 40 weeks PMA varied by gestational age (GA) (P < .001), from 33% for ≤25 weeks, 10% for 26 or 27 weeks, 4% for 28 or 29 weeks, and none for ≥30 weeks. By 40 weeks PMA, 51% with GA ≤27 weeks still needed subsequent exams. Previous exam findings, GA, and PMA were predictive of the development of type 1 ROP (area under the curve, 0.78) or mature retina (area under the curve, 0.85).
Conclusions:
This analysis provides the opportunity for development of an ROP approach to estimate resource needs in the neonatal intensive care unit and to facilitate communication with families when planning discharge or transfer.
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