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Published on: April 2, 2021
Risk factors associated with Retinopathy of Prematurity development and progression
Nieves de Las Rivas Ramírez1,2, Guillermo Luque Aranda3, Francisca Rius Díaz4
1Department of Ophthalmology, Hospital de la Serranía, Ronda-San Pedro, Km 2, 29400, Ronda, Málaga, Spain. nievesdelasrivas@gmail.com.
Insights
Retinopathy of Prematurity (ROP) affects nearly half of high-risk infants. Key risk factors for ROP development include gestational age and oxygen therapy, while progression is linked to oxygen duration and sepsis.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health
Background:
- Retinopathy of Prematurity (ROP) is a complex condition influenced by numerous prenatal and postnatal factors.
- Identifying specific risk factors is crucial for effective management and prevention strategies.
Purpose of the Study:
- To determine the incidence of ROP in a cohort of preterm infants.
- To identify and analyze the risk factors associated with ROP development and progression.
Main Methods:
- Retrospective analysis of data from preterm infants screened for ROP between 2015 and 2018.
- Inclusion criteria: birth weight ≤1.500g and/or gestational age <32 weeks, or specific criteria for higher birth weight/gestational age infants requiring prolonged oxygen or unstable course.
- Statistical analysis including univariate and multivariate assessments to identify independent risk factors.
Main Results:
- ROP developed in 44.7% of the infants (202/452).
- ROP progression occurred in 32.7% of ROP infants (66/202).
- Independent risk factors for ROP development: gestational age, oxygen therapy, weight at 28 days, mechanical ventilation duration, non-invasive ventilation, surfactant administration, and late-onset sepsis.
- Independent risk factors for ROP progression: oxygen therapy duration, late-onset sepsis, and weight at 28 days.
Conclusions:
- The risk factors for ROP development and progression differ significantly.
- Gestational age, oxygen therapy, and sepsis are critical factors to monitor in preterm infants.
- Findings aid in optimizing screening protocols, enabling early diagnosis, and guiding targeted ROP treatment, potentially reducing unnecessary examinations.
Abstract:
Several studies propose that Retinopathy of Prematurity (ROP) is a multifactorial disorder implicating many prenatal and postnatal factors. The objective of our study was to determine the incidence and the risk factors that influenced ROP development and progression. We retrospectively compiled data of preterms with birth weight (BW) ≤ 1.500 g and/or gestational age (GA) < 32 weeks, or BW between 1.501 and 2.000 g and/or GA ≥ 32 weeks with oxygen supply > 72 h or unstable clinical course screened for ROP in Regional University Hospital of Málaga from 2015 to 2018. 202 infants (44.7%) developed ROP and 66 exhibited progression (32.7% of ROP infants). In the univariate analysis, many risk factors were associated with ROP. In the subsequent multivariate analysis, GA, oxygen therapy and weight at 28 days of life, mechanical ventilation duration, non-invasive ventilation, surfactant administration and late-onset sepsis were independently associated with the development. However, oxygen therapy duration, late-onset sepsis and weight at 28 days were associated with the progression. The ROP development and progression risk factors were different. Our results are important to facilitate screening, early diagnosis and ROP treatment while reducing unneeded examinations.
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