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Risk factors associated with retinopathy of prematurity: a study from Oman
1Department of Pediatrics, Mansoura University, Mansura, Egypt.
Insights
Retinopathy of prematurity (ROP) affects 34% of premature infants. Lower birth weight, gestational age, and total parenteral nutrition are key independent risk factors for ROP development and severity.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early identification of risk factors is crucial for timely intervention and prevention of vision loss.
Purpose of the Study:
- To identify risk factors associated with the development and severity of ROP in premature infants.
- To determine independent predictors of ROP using logistic regression analysis.
Main Methods:
- Prospective study conducted at Sultan Qaboos University Hospital.
- Screening of 73 premature infants for ROP.
- Statistical analysis including stepwise logistic regression.
Main Results:
- 25 out of 73 (34%) premature infants developed ROP.
- Nine initial risk factors identified, including low birth weight, prematurity, apnoea, blood transfusion, mechanical ventilation, sodium bicarbonate use, total parenteral nutrition, intraventricular hemorrhage, and sepsis.
- Independent risk factors identified: birth weight, gestational age, and total parenteral nutrition.
- ROP severity was inversely proportional to birth weight and gestational age.
Conclusions:
- Birth weight, gestational age, and total parenteral nutrition are independently associated with ROP development.
- The apparent association of other factors may be confounded by treatment duration and illness severity.
- Gestational age and birth weight are critical determinants of ROP severity.
Abstract:
In a prospective study at Sultan Qaboos University Hospital, out of 73 premature infants screened for retinopathy of prematurity (ROP), 25 (34 per cent) developed the disease. Nine significant risk factors were found to be associated with the development of ROP. These factors were lower birth weight, shorter gestational age, apnoea, top-up blood transfusion, mechanical ventilation, receiving sodium bicarbonate for correction of metabolic acidosis, total parenteral nutrition, intraventricular haemorrhage, and sepsis. However, with stepwise logistic regression analysis, only birth weight, gestational age, and total parenteral nutrition were found to be independently associated with the development of ROP. The severity of ROP was significantly inversely proportional to both birth weight and gestational age. The tendency for the association of some risk factors to disappear when subjected to more stringent analysis (logistic regression) suggests that this association is more likely to be due to the length of treatment (particularly oxygen exposure and mechanical ventilation) and the overall severity of initial illness.