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Exploring Retinopathy of Prematurity: Insights from the First USAID-Funded Screening Program in KPK, Pakistan
Nazli Gul1, Sadia Sethi2, Imran Ahmad3
1Nazli Gul, FCPS (Ophthalmology, Pediatric Ophthalmology& Strabismus), CHPE Professor & Chairperson, Department of Ophthalmology, MTI-Khyber Teaching Hospital, Peshawar, Pakistan.
Insights
Retinopathy of prematurity (ROP) affects premature infants. Key risk factors include low gestational age, postnatal oxygen therapy duration, and neonatal diseases, highlighting areas for preventative care.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Understanding its incidence and risk factors is crucial for effective screening and management strategies.
Purpose of the Study:
- To investigate the incidence, demographics, and associated risk factors of Retinopathy of prematurity (ROP).
Main Methods:
- A multi-centered prospective cross-sectional study was conducted involving 840 screened infants.
- Inclusion criteria included infants born at ≤ 35 weeks gestation, birth weight ≤ 2kg, or NICU admission for ≥ three days.
- Screening occurred at 3-4 weeks post-birth or 31 weeks post-conception, with follow-up until complete temporal retinal vascularization.
Main Results:
- Out of 622 infants included, 98 (15.8%) had ROP. Significant risk factors identified through multivariate analysis included gestational age, postnatal oxygen therapy, duration of oxygen therapy, birth weight, blood transfusion, and neonatal diseases.
- Male infants (56.1%) and those born between 26-30 weeks gestation (66.3%) were predominantly affected.
- A high percentage (99%) received postnatal oxygen therapy, and 24.5% had neonatal diseases.
Conclusions:
- Gestational age, postnatal oxygen therapy, and neonatal diseases are significant factors associated with the development of ROP.
- These findings underscore the importance of monitoring these factors in high-risk infants.
- Targeted interventions and closer monitoring can potentially reduce the incidence and severity of ROP.
Objective:
To investigate incidence, demographics and risk factor associated with Retinopathy of prematurity.
Methods:
It was multi-centered prospective cross sectional study. Department of Ophthalmology at Khyber Teaching Hospital conducted this study, from February 2022 to September 2023 in collaboration with three teaching hospitals based in Peshawar. It was funded by United States Agency for International Development (USAID) with Grant No. CBP051. Infants born at ≤ 35 weeks, or birth weight ≤ 2kg, or admitted to Neonatal Intensive Care Unit (NICU) for ≥ three days were included. Screening was conducted at ≥3-4 weeks after birth or 31 completed weeks post-conception, whichever came first. Endpoint for follow-up was complete vascularization of temporal retina.
Results:
It included 622 of 840 screened infants, with 98(15.8%) ROP cases. Among diagnosed, 56.1% were males, 66.3% born between 26-30 weeks, and 63.3% with birth weight between 0.6-1.5 kg. 62.2% were at 1-4 months of age, 98.9% had screening weight range 1-3 kg, 99% received postnatal oxygen therapy, and 24.5% had neonatal diseases. In multivariate analysis, risk factors including gestational age (AOR 0.793, 95% CI 0.69-0.90), postnatal oxygen therapy (AOR 40, 95% CI 1.9-817), duration of postnatal oxygen therapy (AOR 1.05, 95% CI 1.02-1.07), birth weight (AOR 0.3, 95% CI 0.125-0.725), blood transfusion (AOR 349, 95% CI 17.7-9601), and neonatal diseases (AOR 2.4, 95% CI 1.2-4.8) were found significant.
Conclusions:
Gestational age, postnatal oxygen therapy and neonatal disease are significant factors associated with ROP.
