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Analysis of risk factors for retinopathy of prematurity: a single-center retrospective cohort study
1Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Insights
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. This study found that prolonged non-invasive ventilation, hypophosphatemia, prolonged hospital stay, and apnea are key risk factors for ROP in premature infants.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Pediatric Critical Care
Background:
- Retinopathy of prematurity (ROP) is a significant cause of preventable childhood blindness globally.
- Identifying perinatal and postnatal risk factors is crucial for ROP prevention strategies.
Purpose of the Study:
- To analyze perinatal and postnatal risk factors associated with ROP development in premature infants.
- To focus on potentially modifiable factors for ROP prevention.
Main Methods:
- Retrospective cohort study of 346 preterm infants undergoing ROP screening.
- Comprehensive data collection including demographics, maternal factors, clinical interventions, respiratory support, and metabolic disorders.
- Multivariate logistic regression analysis of variables with P<0.05 in bivariate analysis.
Main Results:
- ROP developed in 4.91% (17/346) of preterm infants.
- Significant independent risk factors for ROP included duration of non-invasive ventilation (OR=1.49), hypophosphatemia (OR=2.29), prolonged hospital stay (OR=1.35), and apnea (OR=2.01).
- ROP group had higher rates of bronchopulmonary dysplasia and longer time to full enteral feeding.
Conclusions:
- Novel associations found between metabolic derangements, particularly hypophosphatemia, and ROP development.
- Optimizing metabolic parameters, respiratory support, and nutritional management may offer new avenues for ROP prevention.
- Findings highlight the importance of addressing modifiable factors in ROP management.
Background:
Retinopathy of prematurity (ROP) remains a significant cause of preventable childhood blindness worldwide. This study aimed to analyze perinatal and postnatal risk factors associated with ROP development in premature infants, with particular focus on potentially modifiable factors.
Methods:
This retrospective cohort study included 346 preterm infants who underwent ROP screening. Comprehensive data collection included demographic characteristics, maternal factors, clinical interventions, respiratory support parameters, and metabolic disorders. Variables with P<0.05 in bivariate analysis were included in multivariate logistic regression.
Results:
Among 346 preterm infants, 17 (4.91%) developed ROP. Multivariate analysis identified several significant independent risk factors for ROP development. Duration of non-invasive ventilation showed increased risk [odds ratio (OR) =1.49; 95% confidence interval (CI): 1.2-1.8; P=0.002], as did hypophosphatemia (OR =2.29; 95% CI: 1.2-3.5; P<0.001). Prolonged hospital stay (OR =1.35; 95% CI: 1.2-1.5; P=0.005) and apnea (OR =2.01; 95% CI: 1.2-2.1; P=0.03) were also significant risk factors. The ROP group demonstrated significantly higher rates of bronchopulmonary dysplasia (64.71% vs. 21.88%; P<0.001) and required longer time to achieve full enteral feeding (35.0±17.10 vs. 24.64±15.17 days; P=0.006).
Conclusions:
This study identified novel associations between metabolic derangements (particularly hypophosphatemia) and ROP development. The findings suggest that optimizing metabolic parameters, respiratory support, and nutritional management may offer new opportunities for ROP prevention.
