Abstract
PurposeThe present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants.Methods A retrospective cohort study was conducted on infants who had undergone screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age 28 weeks), extremely low-birth-weight ( 1000 g), and multiple-gestation (MG) infants.ResultsThe prevalence of ROP was 27.28% ( = 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion ( < 0.0001, < 0.0001, and = 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP ( < 0.0001) were observed in EP and ELBW infants. Birth weight ( = 0.088), history of transfusion ( = 0.066), and intubation ( = 0.053) were not associated with increased risk of ROP in EP infants, while gestational age ( = 0.037) and history of transfusion ( = 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P < 0.001) and birth weight ( = 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis.ConclusionROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines.
Highlights
Retinopathy of prematurity (ROP) is the leading cause of visual impairment in premature infants and is characterized by abnormal peripheral retinal vascularization.[1]
Gestational age and birth weight are the two most well-established risk factors for ROP, with other factors such as oxygen therapy, history of transfusion, sepsis, and anemia being less significantly associated with ROP.[5]
The rate of ROP reported in the literature ranges from 11.4 to 44% due to the differences in economic status, ethnicity, genetics, practice setting, screening programs, and level of perinatal care at the respective institutions.[6,7,8,9,10,11,12,13,14]
Summary
Retinopathy of prematurity (ROP) is the leading cause of visual impairment in premature infants and is characterized by abnormal peripheral retinal vascularization.[1] The incidence of ROP is influenced by several factors including gestational age, birth weight, genetics, ethnicity, and level of neonatal care. Advances in prenatal and neonatal care have resulted in increasing rates of ROP in the developing world.[2,3,4]. Gestational age and birth weight are the two most well-established risk factors for ROP, with other factors such as oxygen therapy, history of transfusion, sepsis, and anemia being less significantly associated with ROP.[5] ROP is diagnosed only in a minority of premature infants, with a smaller subset requiring intervention. Better understanding of risk factors of progression to ROP, especially in those cases requiring treatment, would allow for more effective screening programs.[5, 6]
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