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Retinopathy of prematurity: incidence and risk factors
Insights
Very low-birth-weight infants had high retinopathy of prematurity (ROP) rates despite oxygen monitoring. Key risk factors for ROP included apnea, prolonged nutrition, transfusions, and abnormal blood gases, especially hypocarbia.
Area of Science:
- Neonatology
- Ophthalmology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant concern in very low-birth-weight (VLBW) infants.
- Previous monitoring of oxygen use did not prevent a high incidence of ROP.
Purpose of the Study:
- To identify risk factors associated with the development of ROP in VLBW infants.
- To investigate factors contributing to severe ROP, particularly hypocarbia.
Main Methods:
- Retrospective review of medical records for 65 VLBW infants (birth weight 501-1,250 g) surviving between 1979-1980.
- Analysis of 32 potential risk factors, comparing infants with and without ROP.
Main Results:
- No significant differences in birth weight or gestational age between ROP and non-ROP groups.
- Significant risk factors for ROP included apnea with mask/bag ventilation, prolonged parenteral nutrition, blood transfusions, hypoxemia, hypercarbia, and hypocarbia.
- A strong association was found between hypocarbia and severe ROP.
Conclusions:
- Specific clinical events and physiological disturbances are significant risk factors for ROP in VLBW infants.
- Hypocarbia is a critical factor in the development of severe ROP, necessitating careful management of ventilation and blood gas levels.
Abstract:
A high incidence of retinopathy of prematurity (ROP) was found in the very low-birth-weight infants discharged from the neonatal intensive care unit during the years 1977 to 1980, in spite of frequent monitoring of oxygen use. Although the yearly incidence of ROP in infants weighing less than 1,500 g varied between 35% to 36%, none were blind. The medical records of 65 infants with a birth weight between 501 and 1,250 g; surviving in 1979 to 1980, were reviewed in order to find risk factors for ROP. There were no significant differences between the 34 infants with ROP and the 31 infants who did not have ROP in mean birth weight or mean gestational age. Of 32 possible risk factors examined, the factors significantly associated with ROP were: apnea with mask and bag ventilation; prolonged parenteral nutrition; number of blood transfusions; and episodes of hypoxemia, hypercarbia, and hypocarbia. A highly significant association between hypocarbia and the development of severe ROP was found.