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Regional variations in retinopathy of prematurity incidence for preterm infants <32 weeks' gestation in China
1Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China.
Insights
Regional disparities in retinopathy of prematurity (ROP) were found in China. Infants in Western China had higher rates of death or ROP compared to those in Eastern China.
Area of Science:
- Neonatology
- Ophthalmology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of vision impairment in preterm infants.
- Data on ROP incidence across different regions in China is limited.
- Regional socioeconomic factors, such as Gross Domestic Product (GDP) per capita, may influence ROP outcomes.
Purpose of the Study:
- To compare ROP incidence and associated care practices in different regions of China.
- To investigate the relationship between regional GDP per capita and ROP outcomes.
- To identify regional disparities in neonatal intensive care for preterm infants.
Main Methods:
- Retrospective cohort study involving 18,579 infants born at <32 weeks gestational age (GA).
- Hospitals were categorized into Eastern, Central, and Western China based on geography and GDP per capita.
- Comparison of ROP incidence, death rates, and care practices across the three regions.
Main Results:
- Infants in Eastern China had higher rates of complete antenatal steroid administration and weight gain velocity.
- The incidence of death or any stage of ROP was highest in Western China (39.2%) and lowest in Eastern China (33.3%).
- Significant regional differences were observed in care practices and ROP outcomes (P < 0.01).
Conclusions:
- Considerable regional disparities exist in ROP incidence among preterm infants in China.
- ROP-related death or incidence is higher in Western China compared to Central and Eastern China.
- Regional economic status appears to correlate with variations in ROP outcomes and care quality.
Objectives:
National-level data on the incidence of retinopathy of prematurity (ROP) in different regions of China is insufficient. This study aimed to compare ROP incidences and care practices in different regions of China and their relationship with regional gross domestic product (GDP) per capita.
Study Design:
Retrospective cohort study.
Methods:
All infants born at <32 weeks gestational age (GA) and admitted to 70 neonatal intensive care units (NICUs) from January 1, 2019, to December 31, 2020, were enrolled. Hospitals were categorised into three regional groups according to geographical locations and GDP per capita from high to low: Eastern, Central, and Western China. The incidence of death or ROP, and care practices were compared among the groups.
Results:
A total of 18,579 infants were enrolled. Median GA was 29.9 (interquartile range 28.4-31.0) weeks and birth weight was 1318.1 (317.2) g. The percentage of GA <28 weeks, complete administration of antenatal steroids, and weight gain velocity during NICU stay were highest in Eastern China and lowest in Western China (all P < 0.01). In Eastern, Central, and Western China, the rates of death or any stage of ROP were 33.3%, 38.5%, and 39.2%, respectively (P < 0.01).
Conclusions:
There were considerable regional disparities in ROP incidence in preterm infants with GA <32 weeks in China. The incidence of death or ROP ranged from high to low in Western, Central, and Eastern China.
