由于增加O2和目标而增加早产视网膜病变的风险增加:一项多中心研究
Michael Isaacs1,2, Shaheen P Shah1,2, Shuan Dai1,2
1Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Journal of paediatrics and child health
|June 20, 2023
概括
增加早产婴儿的氧气和目标,同时降低死亡率,导致早产视网膜病变 (ROP) 的患病率更高. 这就需要个性化的新生儿重症监护室 (NICU) 对ROP查和管理的方法.
科学领域:
- 新生儿医学 新生儿医学
- 眼科医生 眼科 眼科
- 公共卫生 公共卫生
背景情况:
- 早产视网膜病变 (ROP) 是早产婴儿视力损伤的主要原因之一.
- 大型试验推的新生儿最近的氧气 (O2) 和目标增加旨在降低死亡率,但是已知的ROP风险因素.
- 这项研究调查了这些更新的O2指南对ROP患病率的影响.
研究的目的:
- 确定早产新生儿中较高的氧和目标是否增加了早产视网膜病变 (ROP) 的患病率.
- 根据新的氧气指南,评估早产新生儿高风险子组中ROP的风险.
主要方法:
- 一项回顾性队列研究分析了2012年至2018年期间32周妊娠年龄 (GA) 之前出生和/或体重小于1500克的17298名新生儿的数据.
- 为2015年后期的ROP风险 (任何ROP,ROP ≥第2阶段,处理ROP) 计算了调整后的几率比率 (aOR).
- 对新生儿进行了亚分析,GA<28周,<26周,出生体重<1500g和<1000g.
主要成果:
- 任何ROP的风险在2015年后显著增加 (aOR=1.23) 和早产婴儿的GA<28周 (aOR=1.31),<26周 (aOR=1.57),<1500g (aOR=1.24) 和<1000g (aOR=1.34).
- 在GA<28周 (aOR=1.30),<26周 (aOR=1.57),<1500g (aOR=1.18) 和<1000g (aOR=1.26) 的婴儿中,ROP ≥第二阶段也显示出增加的风险.
结论:
- 自2015年以来实施的当前氧气治疗指南导致死亡率降低,但同时增加了ROP的发病率.
- 在新生儿重症监护室 (NICU) 内的ROP查和随访协议的个性化调整对于管理ROP的临床负担至关重要.
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