Independent Risk Factors For Retinopathy Of Prematurity Research Articles

Progress in the study of association between hematological indicators and retinopathy of prematurity (Review).

Retinopathy of prematurity (ROP) is a retinopathy caused by abnormal proliferation of blood vessels in premature infants. It can lead to retinal detachment and, in severe cases, blindness, rendering ROP a critical condition. Advances in neonatal medicine have improved survival rates of low birth weight and low gestational age infants. However, this progress has also led to a rise in incidence of ROP. Currently, premature birth, low birth weight and high postpartum oxygen levels are independent risk factors for ROP. Other factors include mode of delivery, multiple births, anemia, blood transfusion, maternal pregnancy factors, neonatal bronchopulmonary dysplasia, use of surfactants, arterial ductus arteriosus and necrotizing enterocolitis. Laboratory indicators in premature infants such as platelet count, levels of blood glucose, inflammatory cells, lipid and hemoglobin and blood transfusion may also be associated with ROP. However, the etiology and pathogenesis of ROP are not fully understood. A number of factors may influence the onset and progression of ROP, including decreased platelet counts, decreased hemoglobin levels, increased white blood cell counts, increased blood glucose levels, and disorders of lipid metabolism. The present study reviewed the effects of platelet count, hemoglobin, blood glucose, inflammatory cells and factors, blood lipids, and plasma metabolic pathways on ROP.

Role of the brain-sparing effect on retinopathy of prematurity in newborns with fetal growth restriction

Introduction This study aimed to investigate the role of the brain-sparing effect (BSE) on retinopathy of prematurity (ROP) in fetal growth restriction (FGR). Methods In this retrospective study, 127 pregnant women were divided into two groups considering the cerebroplacental ratio (CPR): FGR with abnormal CPR group (n = 74) and the appropriate for gestational age with normal Doppler group (n = 53). CPR was computed using the pulsatility index (PI) and resistance index (RI) to quantitate the waveforms [middle cerebral artery (MCA) PI/umbilical artery (UA) PI and MCA RI/UA RI: a result <1 was taken into account as abnormal]. ROP screening results of newborns were recorded from electronic files. Results After adjusting for co-variants, BSE was not related to ROP (adjusted odds ratio [aOR], 1.06; 95% confidence interval [CI], 0.23–4.95). Gestational age at delivery <30 weeks (aOR, 2.55; 95% CI, 1.04–6.93) and birth weight <1500 g (aOR, 5.15; 95% CI, 1.15–25.2) were independently associated with ROP. Preeclampsia, emergency cesarean section birth, or forty-eight hours completion after the first steroid administration were not associated with ROP. Conclusions Gestational age at delivery <30 weeks and birth weight <1500g are independent risk factors for ROP in FGR whereas the BSE is not a risk factor.

The association between serum 25-hydroxyvitamin D levels and retinopathy of prematurity in preterm infants.

This study aimed to investigate the correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and retinopathy of prematurity (ROP) in premature infants one month after birth. Preterm infants (gestational age <32 weeks) admitted to the Affiliated Hospital of Qingdao University from 2017 to 2022 were divided into ROP and non-ROP groups based on ROP occurrence any stage. Serum 25(OH)D levels and clinical data were compared between the two groups at 1 month after birth, and the relationship between vitamin D levels and ROP was analyzed. Among the 217 premature infants included, 55 (25.35%) were in the ROP group, and 162 (74.65%) were in the non-ROP group. The ROP group had lower gestational age and birth weight, longer invasive ventilation (IV), non-invasive ventilation (NIV), and oxygen therapy times compared to the non-ROP group. Apgar scores, cesarean delivery, and antenatal steroids ratios were lower in the ROP group, while sepsis and pulmonary surfactant utilization ratios were higher (all p < 0.05). Significant differences in serum 25-(OH)D levels were observed among children in the non-ROP group (14.20 ± 5.07 ng/ml), ROP treated group (7.891 ± 1.878 ng/ml), and untreated group (12.168 ± 4.354 ng/ml) (p < 0.001). Multivariate regression analysis identified antenatal steroids as protective factors and lower birth weight, serum 25-(OH)D levels, long-term invasive mechanical ventilation, and sepsis as independent risk factors for ROP in premature infants. Vitamin D, lower birth weight, long-term invasive mechanical ventilation, and sepsis were associated with incidence of ROP in preterm infants. Vitamin D was associated with the severity of ROP, emphasizing the importance of prudent vitamin D supplementation and regular monitoring of serum 25-(OH)D levels.

Thrombocytopenia requiring platelet transfusions is predictive of retinopathy of prematurity in preterm infants.

Recent studies suggest that some hematological parameters and ratios provided by blood count collected on the first day of life may be predictors for the development of retinopathy of prematurity (ROP). The aims of this study were to assess whether hematological parameters and ratios in blood count collected on the first day of life are associated with ROP. Retrospective data collection from electronic clinical files of inborn preterm infants with a gestational age of less than 30 weeks delivered from January 2008 to December 2022, in a level III Neonatal Intensive Care Unit (NICU). We collected detailed clinical and demographic data on the mother, pregnancy, mode of delivery, resuscitation, in-hospital neonatal morbidity, pathological examination of the placenta, and hematological parameters and ratios provided by blood count collected on the first day of life. We compared neonates with or without ROP and performed a subgroup analysis on patients with ROP≥2. We included 140 preterm infants with ophthalmic examination; 81(57.9%) developed ROP. The need for platelet transfusions (OR=5.28; 95% CI: 1.31-21.21; P=0.019) and bronchopulmonary dysplasia (BPD) (OR=5.12; 95% CI: 1.14-22.98; P=0.033) were independent risk factors for ROP. In the multivariate analysis, no associations were found between any of the hematological parameters or ratios studied and ROP. In our study, hematological parameters and ratios on the first day of life were not associated with the development of ROP. However, thrombocytopenia that required platelet transfusions was associated with ROP development and severity.

Retinopathy of Prematurity: Incidence and Risk Factor Analysis in Small for Gestational Age Neonates Compared to Appropriate for Gestational Age.

To analyze the incidence of retinopathy of prematurity (ROP) among preterm neonates who were born small for gestational age (SGA) and appropriate for gestational age (AGA). A prospective cohort study among preterm neonates born <34 weeks of gestational age (GA) and <2000 grams birth weight (BW) was conducted. The neonates were divided into AGA and SGA group. Incidence of ROP and risk factors was compared among the groups. 290 neonates were screened [AGA: 240 (82.8%); SGA: 50 (17.2%)]. The mean birth-weight and gestational age were 1510.7 ± 390.64 grams and 31.4 ± 4.8 weeks, respectively. The incidence of ROP in AGA and SGA was 30.2% and 33%, respectively (P = 0.58), whereas the incidence of type 1 ROP in AGA and SGA was 14% and 19% (P = 0.41). Male sex, anemia, oxygen administration, surfactant administration, sepsis, and PIH were independent significant risk factors for ROP on multivariate analysis. This study showed that both AGA and SGA premature infants have similar incidence of ROP. SGA is not an independent risk factor for ROP.

Serum Zinc Levels in Preterm Newborns and its Relation with Retinopathy of Prematurity

Background With the increased survival of preterm babies, retinopathy of prematurity (ROP) has become the leading cause of preventable childhood blindness. It is caused by oxidative damage to the immature retina and zinc may help in the prevention of ROP owing to its antioxidant properties. Objective To measure serum zinc levels in preterm neonates and study its association with the development of ROP. Methods A total of 360 preterm neonates of gestational age between 28 completed weeks to &lt;37 weeks were included in this observational cross-sectional study. Serum zinc levels of the neonates aging &lt;24 hours of life were measured at the time of admission in NICU by spectrophotometry. Taking the reference range of serum zinc levels between 70 to 150 mcg/dL babies were arbitrarily divided into 2 groups (&lt;70 and &gt;70 mcg/dL). ROP screening was done at appropriate postnatal age by indirect ophthalmoscopy. The results were analyzed by the SPSS software version. Results The mean serum zinc level was 114.99±54.47 mcg/dL. The overall prevalence of ROP was 26%; of which, 10% of neonates had severe ROP (≥stage 3). A significant association was found between gestational age and birth weight with ROP. Oxygen supplementation, respiratory distress syndrome, surfactant use, antibiotic use &gt;7 days, and low serum zinc levels (&lt;70 mcg/dL) were significant risk factors on univariate analysis and after multivariate analysis, gestational age, surfactant use, and low serum zinc levels (&lt;70 mcg/dL) came out to be independent risk factors for ROP. Conclusion There was a statistically significant association of low serum zinc levels with the development of ROP and it was independent of other risk factors associated with ROP.

Retinopathy of Prematurity: A Study of Incidence and Risk Factors in a Tertiary Hospital in Vietnam.

ObjectiveTo determine the incidence and risk factors for the development of retinopathy of prematurity (ROP) in the neonatal intensive care unit (NICU) of Hue Central Hospital, Vietnam.MethodsA prospective study was performed in 214 preterm infants with gestational age (GA) ≤33 weeks and/or ≤1800 grams of birth weight (BW) or infants with a GA >33 weeks and a BW >1800 grams with an unstable clinical course who were screened for ROP in Hue Central Hospital, Vietnam.ResultsFifty-eight infants (27.1%) developed ROP; 39.7% cases were stage 1, 34.5% cases were stage 2, and 25.8% cases were stage 3. Gestational age (GA), birth weight, anemia, sepsis, respiratory distress syndrome, total days on oxygen supplementation > 1 week, continuous positive airway pressure (CPAP), mechanical ventilation, blood transfusion, and surfactant had a significant association with ROP in univariate analysis (p<0.05). Using multivariate analysis, GA less than 32 weeks, sepsis, and CPAP/mechanical ventilation remained independent risk factors for ROP development.ConclusionThe incidence of ROP in Vietnam was 27.1%. A GA less than 32 weeks, sepsis, and CPAP/mechanical ventilation are important risk factors for developing ROP.

A Good Way to Reduce Screening for Retinopathy of Prematurity: Development of the ROP Model in a China Preterm Population.

Importance: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. Without treatment, more than 45% of eyes may suffer permanent vision loss. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP.Method: All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). The significant results were analyzed in a backward selection multivariate logistic regression model. Receiver operating characteristic (ROC) curves and a nomogram were drawn.Results: The study included 2,040 infants who underwent ROP screening. The weight gain rate [OR, 2.65; 95% confidence interval (CI), 1.49–1.21 ≤ 12 g/d vs. > 18 g/d; P = 0.001], blood transfusion (OR, 2.03; 95% CI, 1.14–3.64; P = 0.017), invasive mechanical ventilation (OR, 1.74; 95% CI, 1.15–2.66; P = 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51; 95% CI, 1.00–2.28; P = 0.048) were four new statistically independent risk factors in addition to GA and BW. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92; P < 0.001).Conclusions and Relevance: These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The ROP risk can be calculated manually or represented by a nomogram for clinical use.

Early Risk Factors for Retinopathy of Prematurity in Very and Extremely Preterm Chinese Neonates.

Objective: To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in very and extremely preterm (28+0- <32+0, and <28+0 weeks gestation, respectively) neonates, and the predictive factors for ROP in the early hours after birth and during hospitalization.Methods: Using a prospective database supplemented with a retrospective chart review, we identified preterm neonates born at gestation <32 weeks at the University of Hong Kong-Shenzhen Hospital between January 2015 and August 2018. Demographic and clinical variables were studied including indicators of disease acuity in the first 24 h after birth. We also compared the difference in risk factors between survivors with ROP and survivors without ROP.Results: During the study period, there were 529 preterm neonates admitted to our neonatal intensive care unit with 120 (23%) born at <32 weeks' gestation. Thirteen (11%) neonates died. Among the 107 survivors, 23 (21%) had ROP, of whom five (22%) received laser and/or medical therapy for severe ROP. Compared with survivors without ROP, infants with ROP had lower mean blood pressure in the first 12 and 24 h after birth, respectively. Using multivariate regression, gestation age, mean blood pressure in the first 12 h after birth, hospital length of stay, and total days of blood gases pH <7.2 were independent risk factors for ROP.Conclusions: In this small cohort of Chinese neonates born <32+0 weeks' gestation, survivors with ROP had a lower blood pressure in the early hours after birth, younger gestation, longer hospital stay, and duration of acidosis when compared to those without ROP.

Aerosol therapy in relation to retinopathy of prematurity in mechanically ventilated preterm infants

BackgroundAerosol administration is increasingly being used as a therapeutic intervention for mechanically ventilated preterm infants. However, the effects of inhalation therapy on retinopathy of prematurity (ROP) have not yet been explored.MethodsA retrospective cohort study was conducted in a tertiary level neonatal intensive care unit (NICU) from 2011 to 2013. All preterm infants with a gestational age (GA) of 24~29 weeks receiving invasive intubation for more than 1 week in the NICU were included. Infants with severe congenital anomalies were excluded. ROP was defined as stage II or greater according to medical records by ophthalmologists. A multivariate logistic regression model was used to estimate the risk of ROP in relation to inhalation therapy after adjusting for confounders.ResultsIn total, 205 infants were enrolled in this study, including 154 with inhalation therapy and 51 without inhalation therapy. Univariate analyses showed an association of inhalation with the following characteristics: sex (p = 0.047), GA (p = 0.029), sepsis (p = 0.047), bronchopulmonary dysplasia (BPD) (p < 0.001), and ROP (p = 0.001). Furthermore, logistic regression analysis indicated that inhalation therapy was an independent risk factor for ROP (odds ratio (OR) = 2.639; 95% confidence interval (CI) = 1.050~6.615). In addition, infants with a GA of 24~25 weeks (OR = 6.063; 95% CI = 2.482~14.81) and 26~27 weeks (OR = 3.825; 95% CI = 1.694~8.638) were at higher risk of ROP than those with a GA of 28~29 weeks. Other factors – including sex, sepsis, BPD, and delivery mode – did not carry significant risk.ConclusionAerosol therapy with pure oxygen delivery is associated with ROP. Clinicians should exercise great caution when conducting aerosol therapy with excess oxygen in mechanically ventilated preterm infants.

133 THE ASSOCIATION OF POSTNATAL GROWTH VELOCITY WITH RETINOPATHY OF PREMATURITY AND BRONCHOPULMONARY DYSPLASIA IN PERTERM INFANTS: A POPULATION BASED RETROSPECTIVE COHORT STUDY

Retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) are associated with multiple risk factors, but the etiologies and pathophysiology of these conditions are not completely understood. Recent evidence suggests that poor postnatal weight gain may contribute to the development of both ROP and BPD. This study aimed to investigate if in preterm infants, poor growth velocity, defined as weight gain velocity (WGV) <15 g/kg/day, in the first 4 weeks of life is a risk factor for ROP and BPD. A total of 725 preterm infants with gestational age < 30 weeks born between 2003 and 2015 were retrospectively reviewed. The primary outcomes assessed were development of ROP ≥ stage 3 and development of BPD, defined as need for supplemental oxygen for ≥28 days and a need for ≥30% oxygen/nasal CPAP/ mechanical ventilation at 36 weeks PMA/discharge. WGV was calculated using exponential model of estimating growth velocity as follows: WGV = (1000 x ln (Wn/W1))/(Dn − D1); wherein, W1 is birth weight (BW), Wn is weight at discharge/desired time point, D1 is 0 and Dn is day at discharge/desired time point. Of the 725 infants, 670 were categorized as having poor WGV. In the poor WGV cohort, the incidence of ROP was significantly higher than in the good WGV cohort (adjusted odds ratio, 3.257; 95% confidence interval, 1.999–10.638, P= 0.039). Similarly, in the poor WGV cohort, the incidence of BPD was significantly higher than in the good WGV cohort (adjusted odds ratio, 3.497; 95% confidence interval, 1.464–9.524; P= 0.003). After performing multivariable logistic regression controlling for maternal age, maternal diabetes, pregnancy-induced hypertension, clinical chorioamnionitis, antenatal corticosteroid, cesarean section, sex, gestational age, BW, Apgar score (AS) (1 and 5 min), respiratory distress syndrome (RDS) requiring surfactant, patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), severe intraventricular hemorrhage (IVH) (grade III-IV), blood culture positive sepsis, WGV was found to be an independent risk factor for both ROP and BPD (P= 0.000 and P= 0.002 respectively). Similarly, after performing multivariable logistic regression using WGV as a continuous variable, WGV was found to be an independent risk factor for ROP and BPD (P= 0.002 and P= 0.015). Poor weight gain velocity in the first 4 weeks of life is an important and independent risk factor for ROP and BPD.

The prognostic value of lymphocyte-to-monocyte ratio in retinopathy of prematurity.

To evaluate the associations between development of retinopathy of prematurity (ROP) and serum lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). A retrospective cohort study was performed, involving infants who were screened for ROP from January 2015 to December 2015. Preterm newborns of ≤32 gestational weeks with ROP were enrolled as the observation group, and non-ROP infants were enrolled as the control group, whose complete blood cell were measured within the first 24h of life. The levels of NLR, LMR and PLR were determined in all groups. The data obtained were analyzed using univariate and multivariate logistic regression analysis. In this study, 40 cases of ROP were enrolled and 40 cases of non-ROP as controls. The LMR levels were significantly higher (P<0.001) in ROP group (3.96±1.16) compared to non-ROP group (2.85±0.79). The NLR levels were significantly lower (P=0.035) in ROP group {median [interquartile range (IQR)], 0.88 (0.67-1.46)} compared to non-ROP group [median (IQR), 1.20 (0.85-1.89)]. The median PLR values were 61.99 (IQR, 50.23-75.98) in ROP group and 69.24 (IQR, 55.52-88.12) in non-ROP group (P=0.104). Logistic regression analysis suggested that LMR was an independent risk factor for ROP (OR: 0.275; 95% CI: 0.134-0.564; P=0.001). The findings demonstrate that higher LMR is independently and significantly associated with the development of ROP, and the LMR may be invoked as a predictive tool for identifying risk for ROP.

Incidence and risk factors of retinopathy of prematurity in two neonatal intensive care units in North and South China.

Background:To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in two Neonatal Intensive Care Units in North and South of China, respectively.Methods:We studied data concerning 472 infants with gestational age (GA) ≤34 weeks or birth weight (BW) ≤2000 g who were admitted to the Zhujiang Hospital of Southern Medical University and the Fourth Hospital of Shijiazhuang between January 1, 2011 and December 31, 2011. Clinical information about perinatal neonates was collected and was confirmed by reviewing medical charts. The incidence and severity of ROP were assessed in the screened population. Main outcome measures are the incidence and severity of ROP. The relationship of clinical risk factors and the development of ROP were analyzed.Results:The overall incidence of ROP was 12.7%, and the overall incidence of type 1 ROP was 2.3%; 9.4% of infants in Zhujiang Hospital had ROP compared to 15.0% infants in the Fourth Hospital of Shijiazhuang developed ROP, and the difference is statistically significant. ROP was significantly associated with GA (odds ratio [OR]: 0.77 [0.62–0.95], P = 0.015), BW (OR: 0.998 [0.996–0.999], P = 0.008), maternal supplemental oxygen administration before and during delivery (OR: 4.27 [1.21–15.10], P = 0.024) and preeclampsia (OR: 6.07 [1.73–21.36] P = 0.005). The risk factors for ROP are different in two hospitals. In Zhujiang Hospital, BW is the independent risk factors for ROP while GA, BW and preeclampsia in the Fourth Hospital in ShijiazhuangConclusions:Retinopathy of prematurity incidence is different based on area. Incidence of ROP is still high in China. More efforts need to prevent ROP.

Postnatal weight gain in the first two weeks as a predicting factor of severe retinopathy of prematurity requiring treatment.

PurposeThis study aimed to investigate the relative weight gain at 2-week intervals up to 6 weeks after birth to predict retinopathy of prematurity (ROP) requiring treatment among very low birth weight infants.MethodsA total of 211 preterm infants with birth weights <1,500 g and gestational age <32 weeks were retrospectively reviewed. The main outcome was the development of ROP requiring treatment. Body weight measurements were recorded daily. Relative weight gains (g/kg/day) were calculated at the second, fourth, and sixth week after birth.ResultsOf the 211 infants, 89 developed ROP, of which 41 spontaneously regressed and 48 with early treatment of ROP type I required laser treatment. The relative weight gain at 2, 4, and 6 weeks postnatal age was significantly lower in infants with ROP requiring treatment than in infants without ROP or those with spontaneous regression (P<0.001, P=0.005, and P=0.004, respectively). On logistic regression, poor relative weight gain in the first 2 weeks was found to be related to ROP requiring treatment (adjusted odds ratio, 0.809; 95% confidence interval, 0.695-0.941; P=0.006). Relative weight gain at 2 weeks postnatal age was significantly lower in infants with ROP requiring treatment compared to that in ROP requiring no treatment (P=0.012).ConclusionPoor postnatal weight gain in the first 2 weeks of life is an important and independent risk factor for ROP requiring treatment. Postnatal weight gain can predict the development of severe ROP requiring treatment.

Incidence and risk factors for retinopathy of prematurity in extreme low birth weight Chinese infants

The objective of this study is to determine the incidence and risk factors of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) Chinese infants. A retrospective medical record review of all ELBW (≤1,000 g) neonates screened for ROP from 2007 to 2012 was performed in Hong Kong. ROP screening was conducted at 2 neonatal intensive care units by 3 pediatric ophthalmologists using the Royal College of Ophthalmologists ROP guideline and the International Classification of ROP. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP. In 131 ELBW Chinese infants, the mean gestational age (GA) and birth weight (BW) were 27.3 ± 3.3 weeks and 806.9 ± 133.7 g, respectively. The incidence of ROP and Type 1 ROP was 53.4 and 14.5 %, respectively. For ROP, a lighter BW, smaller GA, vaginal delivery, postnatal hypotension, inotrope use, bronchopulmonary dysplasia, surfactant use, invasive mechanical ventilation, and supplementary oxygen were independent risk factors for ROP, while PET was protective (P ≤ 0.02). On multivariate analysis, a smaller GA was a risk factor, while PET and congenital heart disease were protective for ROP development (P ≤ 0.01). For Type 1 ROP, a lighter BW, smaller GA, surfactant use, and invasive mechanical ventilation were independent risk factors for ROP, while PET was protective (P ≤ 0.02). There were no significant covariates on multivariate analysis for Type 1 ROP. In ELBW, preterm Chinese infants, a smaller GA was a risk factor for ROP, while PET and congenital heart disease were protective for ROP development in multivariate analysis.

Incidence of retinopathy of prematurity in southwestern China and analysis of risk factors.

BackgroundThe aim of this study was to screen for retinopathy of prematurity (ROP) in southwestern China and understand the prevalence and risk factors of ROP, which may provide evidence useful in the prevention and treatment of ROP.Material/Methods1864 preterm infants (gestational age of <37 weeks and birth weight of ≤2500 g) underwent ROP screening from January 2009 to November 2012 in Southwest China. The medical information of infants during perinatal period was reviewed, and risk factors of ROP were determined. A total of 1614 infants were recruited for final analysis.ResultsIncidence of ROP was 12.8%. The first, second, third, and fourth stage of ROP was found in 64.6%, 29.6%, 3.4%, and 0.5% of infants, respectively. No fifth stage of ROP was observed. In addition, 7.7% of infants required surgical intervention. In our Department of Neonatology, the incidence of ROP was 20.0%, which was significantly higher than in non-hospitalized patients (9.9%). The incidence of ROP remained unchanged over the years. Independent risk factors of ROP included low birth weight (p=0.049), low gestational age (p=0.008), days of oxygen supplementation (p=0.008), and myocardial injury after birth (p=0.001).ConclusionsThe prevalence of ROP in preterm infants is relatively high in Southwest China, and low birth weight, low gestational age, days of oxygen supplementation, and myocardial injury after birth are independent risk factors for ROP.

Patent Ductus Arteriosus and Indomethacin Treatment as Independent Risk Factors for Plus Disease in Retinopathy of Prematurity

To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment. Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment. A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP. PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP.

Incidence of Retinopathy of Prematurity and Risk Factors Among Premature Infants at a Neonatal Intensive Care Unit in Canada

To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit and obtain information on risk factors associated with ROP. Four hundred twenty-three infants were screened for ROP between July 2006 and July 2010. Demographic information, clinical data, and risk factors were reviewed. The incidence was 40.4% (171 infants) for ROP, 9.2% (39 infants) for severe ROP, and 5.67% (24 infants) for laser treatment. Mean gestational age and birth weight were significantly lower among infants with ROP versus those without ROP (26 ± 0.13 vs 28.55 ± 0.12 weeks, P < .0001 and 840.5 ±17.49 vs 1,190.24 ± 20.20 g, P < .0001, respectively). Birth weight (P < .001), gestational age (P < .001), mechanical ventilation therapy (P = .039), and necrotizing enterocolitis (P = .019) were independent risk factors for ROP. Gestational age and birth weight were the most significant risk factors for developing ROP. The study population had an elevated percentage of infants with birth weight less than 1,000 g (extremely low birth weight), yet there was no corresponding increase in severe ROP incidence and treatment when compared to other studies.

Changing Spectrum of Retinopathy of Prematurity (ROP) and Variations Among Siblings of Multiple Gestation

To assess the changing spectrum of ROP, and to compare the siblings of multiple gestations with regard to incidence and severity of ROP. A prospective study was done among a total of 158 infants (including 19 twin pairs), selected for ROP screening as per American Academy of Pediatrics (AAP) criteria. Data collected was analysed to assess the changing ROP spectrum in comparison to year 2002 ROP screening data from the authors' centre, and the variations among siblings of multiple gestation. Overall incidence of ROP was about 45.57% in 2009 as compared to 44.60% in 2002. 17 risk factors were found significantly associated with ROP on univariate analysis with low gestational age, low birth weight and multiple gestation (not analyzed in the 2002 data) confirmed as independent risk factors for ROP .The absolute number of subjects with severe ROP (>stage III) has decreased at the authors' centre. Twins with ROP were sicker as compared to the other sibling. Though overall incidence of ROP has remained the same over the last decade at the authors' centre, absolute number of severe forms of ROP has decreased. Multiple gestations may be taken as an independent risk factor for ROP causation. Sicker the twin infant is, the more are the chances that he/she will develop ROP.

Analysis of risk factors of prenature retinopathy

Objective To analyze the incidence and risk factors of retinopathy of prematurity (ROP).Methods 244 premature children 4 weeks after birth, which neonatal gestational age were ＜ 36 weeks, birth weight were ＜ 2 000g,were taken fundus examination.ROP stage at diagnosis, according to international law for the diagnosis and staging.Results 244 patients with varying degrees of premature children with ROP in 49 cases(including 37 cases of ROP Ⅰ ,ROPⅡ of the 10 cases,ROP Ⅲ 2 ,ROP rate was 20.1％.Gestational age,birth weight,oxygen,mother pregnancy complications,acidosis, apnea,PaO2 changes, mechanical ventilation and infection on the incidence of ROP had a significant effect (all P ＜ 0.05) ;and shorter gestational age, birth weight, smaller, ROP incidence higher(all P ＜ 0.05).Conclusion The incidence of ROP and gestational age, birth weight,oxygen, mother pregnancy complications, acidosis, apnea, PaO2 changes and infection, mechanical ventilation and other factors, and the gestational age, birth weight, oxygen, apnea were independent risk factors for ROP. Key words: Retinopathy; Prematurity; Risk factors.