Incidence and Characteristics of Retinopathy of Prematurity Patients With Late Gestational Age and Large Birth Weight in South China.

Xiang Gao,Lisha Wang,Yichi Zhang,Yuqing Lan,Deying Yu,Yunru Liao,Zijing Li,Duoru Lin

doi:10.3389/fmed.2022.712759

Xiang Gao, Lisha Wang + Show 6 more

Open Access

https://doi.org/10.3389/fmed.2022.712759

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Abstract

PurposeTo investigate the incidence and characteristics of retinopathy of prematurity (ROP) premature infants with late gestational age (GA) and large birth weight (BW) and show a 7-year trend of ROP incidence in South China.MethodsThis retrospective, cross-sectional study included premature infants who received ROP screening in a 7-year period (from 2010 to 2016) at the Sun Yat-sen Memorial Hospital (SYSMH), Guangzhou, South China. Infants were screened if they had GA <37 weeks or BW <2,500 g. All screened infants were divided into two groups: Group 1 (with both GA ≥ 35 weeks and BW ≥ 1,750 g) and Group 2 (others). The characteristics of ROP infants in Group 1 were analyzed and compared with those in Group 2.ResultsA total of 911 premature infants were screened, with 282 infants in Group 1 and 629 in Group 2. Both the incidences of any ROP (6.7 vs. 8.3%, p = 0.50) and Type 1 ROP (1.4 vs. 1.7%, p = 0.72) in Group 1 were comparable with those in Group 2. Lower proportions of respiratory distress (15.8 vs. 71.2%, p < 0.001), blood transfusion (5.3 vs. 32.7%, p = 0.028), and oxygen administration (31.6 vs. 86.5%, p < 0.001) among ROP patients in Group 1 than those in Group 2 were revealed. Vaginal delivery [OR: 4.73 (1.83–12.26)] was identified as a factor associated with ROP among the infants in Group 1. Forty percent (6/15) of Type 1 ROP in this study would have been missed under the current screening criteria in China (GA ≤ 34 weeks and/or BW ≤ 2,000 g). Trends of increased incidence of Type 1 ROP and decreased BW were exhibited in the 7-year study period.ConclusionsThese findings indicate that even the premature infants with late GA and large BW also have a high risk of developing ROP, especially for those delivered by vagina. The findings may provide a significant reference for ROP screening and neonatal care in South China and other regions with similar conditions.

Highlights

Retinopathy of prematurity (ROP) is one of the leading causes of potentially preventable and treatable blindness among premature infants worldwide [1]
All Type 1 ROP infants were treated by laser photocoagulation
Group 1 infants were less likely to be diagnosed as respiratory distress (8.5 vs. 66%, p < 0.001) and less likely to have received blood transfusion (1.1 vs.30.2%, p < 0.001) or supplemental oxygen (31.6 vs. 80.6%, p < 0.001) than Group 2

Summary

Introduction

Retinopathy of prematurity (ROP) is one of the leading causes of potentially preventable and treatable blindness among premature infants worldwide [1]. The incidence and risk factors of ROP within the Chinese screening criteria have been well explored [10]. Understanding the incidence and characteristics of ROP with late GA and large BW may help to adjust the screening strategy for the reduction of missed diagnoses. Liu et al [14] used a broader screening range (GA < 37 weeks and BW < 2,500 g) to analyse the incidence and risk factors of ROP in Southwest China. They did not focus on the characteristics of ROP with late GA and large BW and analyzed the incidence of ROP according to GA and BW separately

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