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Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants
Claudia Ioana Borțea1, Florina Stoica2, Marioara Boia1
1Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Insights
Birth weight and ventilation are key predictors of retinopathy of prematurity (ROP) in preterm infants. Lower birth weight and the need for ventilation significantly correlate with developing Stage 2 and 3 ROP.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a primary cause of blindness in premature infants.
- Understanding perinatal risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the association between various perinatal characteristics and the incidence of Stage 1-3 ROP.
- To identify significant risk factors for specific stages of ROP using multivariate analysis.
Main Methods:
- A cohort of 247 preterm infants (gestational age < 32 weeks) screened for ROP was analyzed.
- Univariate, multivariate binary, and multivariate multinomial analyses were employed to assess risk factors.
- Perinatal factors included sex, gestational age, birth weight, CRP, LDH, ventilation, CPAP, and surfactant administration.
Main Results:
- The overall incidence of ROP (Stage 1-3) was 66.40%.
- Multivariate analysis identified birth weight (BW) and ventilation as significant predictors of ROP (Stage 1-3).
- BW was significantly correlated with Stage 2 and 3 ROP, while ventilation was significantly correlated with Stage 2 ROP.
Conclusions:
- Gestational age, birth weight, and respiratory support (ventilation, CPAP, surfactant) are significant risk factors for ROP.
- Birth weight and ventilation emerge as critical independent predictors for more severe stages (Stage 2 and 3) of ROP in multivariate models.
Abstract:
Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1-3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1-3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1-3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1-3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.
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