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Clinical factors associated with retinopathy of prematurity
A Prendiville1, W E Schulenburg
1Royal Postgraduate Medical School, Hammersmith Hospital, London.
Insights
Acidosis and hyperoxia are significant risk factors for retinopathy of prematurity in premature infants. Gestational age also plays a role in the development of this serious eye condition.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Public health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Identifying risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To determine the incidence and severity of ROP in low birth weight infants.
- To identify independent risk factors for ROP development in preterm infants (<31 weeks' gestation).
Main Methods:
- Prospective study of 140 infants (<1500 g birth weight) and 117 infants (<31 weeks' gestation).
- Data collection on 34 potential risk factors.
- Multiple logistic regression analysis to identify significant variables.
Main Results:
- 42% of infants (<1500 g) developed ROP; 15% progressed to advanced stages.
- 29% of infants (<31 weeks' gestation) developed ROP.
- Acidosis (pH <7.2), hyperoxia (PaO2 >12 kPa), and gestational age were independently associated with ROP development.
Conclusions:
- Acidosis and hyperoxia are significant risk factors for ROP in preterm infants.
- Gestational age is also a key determinant in ROP development.
- Findings suggest acidosis may be a critical etiological factor in ROP pathogenesis.
Abstract:
In the period from September 1983 until June 1986 a prospective study was carried out to determine the incidence and severity of retinopathy of prematurity in inborn infants of less than 1500 g at birth and the risk factors associated with the development of retinopathy of prematurity in infants of less than 31 weeks' gestation. One hundred and forty four infants were eligible for inclusion in the study. Altogether 140 infants of less than 1500 g birth weight were examined, 42 (30%) of whom developed retinopathy of prematurity. Fifteen of these infants had progression to advanced disease (stage III or stage IV). One hundred and seventeen of the infants were of less than 31 weeks' gestation and 34 (29%) of them developed retinopathy of prematurity. Thirty four risk factors shown previously to be associated with the development of the disease were collected prospectively and analysed using multiple logistic regression analysis to determine the independently significant variables. Three risk factors: acidosis, the number of times that the pH was less than 7.2; hyperoxia, the number of times that arterial oxygen tension was greater than 12 kPa; and gestational age were found to be independently associated with the development of retinopathy of prematurity in these infants. These findings suggest that acidosis may be an important aetiological factor in the pathogenesis of this disease.