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Risk factors for retinopathy of prematurity in extremely preterm Chinese infants
Gordon S K Yau1, Jacky W Y Lee, Victor T Y Tam
1From the Department of Ophthalmology, Caritas Medical Centre (GSKY, JWYL, VTYT); Department of Ophthalmology, The University of Hong Kong (JWYL, IYHW); Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China (CCLL).
Insights
Retinopathy of prematurity (ROP) affects 60.7% of extremely preterm infants. Lower gestational age and lighter birth weight are key risk factors for ROP and Type 1 ROP.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Early identification and management of ROP are crucial for preventing severe visual outcomes.
- Extremely preterm infants (gestational age ≤28 weeks) are at the highest risk.
Purpose of the Study:
- To determine the incidence of ROP and Type 1 ROP in extremely preterm Chinese infants.
- To identify maternal and neonatal risk factors associated with ROP and Type 1 ROP development.
- To explore protective factors against ROP in this vulnerable population.
Main Methods:
- Retrospective review of medical records for extremely preterm neonates screened for ROP (2007-2012).
- Analysis of 33 maternal and neonatal covariates using univariate and multivariate regression.
- Focus on infants with gestational age ≤28 weeks.
Main Results:
- ROP incidence was 60.7%; Type 1 ROP incidence was 16.2%.
- Independent risk factors for ROP included lower gestational age and lighter birth weight.
- Neonatal congenital heart disease and greater gestational age were protective factors against ROP.
Conclusions:
- Lower gestational age and lighter birth weight are significant independent risk factors for ROP and Type 1 ROP.
- Congenital heart disease and increased gestational age may offer protection against ROP.
- Findings highlight the importance of monitoring extremely preterm infants for ROP.
Abstract:
To investigate the incidence and risk factors of retinopathy of prematurity (ROP) and Type 1 ROP in extremely preterm Chinese infants. A retrospective review of medical records was performed of all extremely preterm neonates (gestational age, GA≤28 weeks) screened for ROP from 2007 to 2012 at an ophthalmology centre in Hong Kong. Thirty-three maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP. The mean gestational age (GA) was 26.4±1.3 weeks and the birth weight (BW) was 855.0±199.0 g. The incidence of ROP development was 60.7% and 16.2% for Type 1 ROP. On univariate analysis, 6 risk factors were identified for ROP development including: lighter BW; lower GA; postnatal hypotension; inotrope use; surfactant use; and invasive mechanical ventilation (all P≤0.01). On multivariate analysis, neonatal congenital heart disease and greater GA were protective factors for ROP development (P≤0.04). On the other hand, 4 risk factors were associated with Type 1 ROP development in univariate analysis, including: lower GA, lighter BW, multiple pregnancies, and invasive mechanical ventilation (all P≤0.02); while there was no significant risk factors on multivariate analysis. A lighter BW and lower GA were the only common independent risk factors for both ROP and Type 1 ROP while neonatal congenital heart disease and greater GA were the protective factors against ROP.
