Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants (original) (raw)
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Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates
Early Human Development, 2013
Background: Retinopathy of prematurity (ROP) is a multifactorial disease, but little is known about its relationships with neonatal nutritional policies. Human, maternal milk is the best possible nutritional option for all premature infants, including those at high risk for severe complications of prematurity, such as ROP. Objective: This is a secondary analysis of data collected during two multicenter RCTs performed consecutively (years 2004 through 2008) by a network of eleven tertiary NICUs in Italy. The two trials aimed at assessing effectiveness of fluconazole prophylaxis (
Clinical Ophthalmology, 2013
This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP) in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012. Methods: A prospective cohort study was undertaken in infants weighing , 1250 g and maternal postmenstrual age , 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation), packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography. Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5%) were male and 80 cases (52.5%) were female. Of the cases screened, 100 (65.6%) had no ROP, 52 had ROP of any stage (34.4%), and 27 (18%) had stage 1, five (3.3%) had stage 2, 17 (11.5%) had stage 3, and three (1.6%) had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6%) had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age. Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive care units at three obstetric hospitals in Alexandria. The main risk factors for development of threshold ROP by regression analysis were low birth weight, gestational age, method of ventilation, need for packed red blood cell and/or plasma transfusion, occurrence of sepsis, intraventricular hemorrhage, and patent ductus arteriosus but not neonatal indirect hyperbilirubinemia. We suggest that both immaturity and compromised pulmonary function are both important etiological factors in the development of ROP.
Survey on retinopathy of prematurity (ROP) in Italy
Italian Journal of Pediatrics, 2013
Background: This study aims to investigate the incidence and the relative risk factors of retinopathy of prematurity (ROP) and posterior-ROP (P-ROP): ROP in Zone I and posterior Zone II, as well as to analyze the occurrence of surgical treatment of ROP and to evaluate the short term outcome of the disease in Italy. Methods: It is a prospective multicenter observational study; all infants with a birth weight (BW) ≤ 750 g and/or a gestational age (GA) ≤27 weeks born between January 1 st 2008 and December 31 st 2009 in 25 III level Italian neonatal intensive care units were eligible for the study. Results: 421 infants were examined: 265 (62.9%) developed ROP and 102 (24.2%) PROP. Following the multivariate analysis erythropoietin-therapy (p < 0.0001) and intraventricular hemorrhage (IVH) (p = 0.003) were significantly associated with ROP while gestational age ≤24 weeks (p = 0.011) and sepsis (p = 0.002) were associated with the onset of PROP. Eighty nine infants (34%) required surgical treatment; following the multivariate analysis PROP was an independent factor associated with the need of surgical treatment (p < 0.0001). A favorable outcome was reported in 251 (94.7%) newborns affected by ROP. Adverse outcome occurred in 14 patients: all of them underwent surgery and showed PROP. Conclusions: PROP is the most aggressive type of ROP. It associates with lower GA and sepsis. Obstetricians and Neonatologists must focus on the reduction of severe preterm births and on the prevention of neonatal early and late onset sepsis in order to reduce the incidence of PROP .
Retinopathy of prematurity: Results from 10 years in a single neonatal intensive care unit
Journal of Pediatric and Neonatal Individualized Medicine, 2017
Introduction: Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina of preterm newborns and is an important and preventable cause of visual impairment in childhood. This study aimed to assess the incidence and main risk factors associated with the development of ROP in the last 10 years at Hospital Prof. Doutor Fernando Fonseca in Lisbon, Portugal. Methods: Observational and retrospective study conducted between 2005 and 2014 at Hospital Prof. Doctor Fernando Fonseca. The study included newborns of gestational age < 32 weeks. We analyzed maternal, prenatal and neonatal factors associated with the development of ROP. Statistical analysis were performed with Statistical Package for Social Sciences (SPSS®) software. Univariate and multivariate analyses were performed and a multiple logistic regression model was carried out with a significance level α = 0.05. Results: 527 premature infants with a gestational age < 32 weeks were studied, of which 165 develo...
Incidence and outcome of retinopathy of prematurity in neonates and correlation with risk factors
2017
BACKGROUND: To study the incidence and risk factors predisposing to retinopathy of prematurity (ROP) in at-risk newborns at SNCU of a tertiary care hospital in Vadodara METHODS: Preterm infants with birth weight < 1500gm and gestation <=34 weeks were screened for ROP at 4 weeks after birth or 31-33 weeks post conceptional age, whichever was later. Infants with birth weight 1500 to 2000 gm and gestation >34 weeks were screened only if they had additional risk factors. Those found to have high risk ROP were treated. RESULTS: The incidence of ROP in 113 infants who were screened was 30.9%. No ROP was found in infants weighing >2000gm or with a gestational age more than 37weeks. Risk factors predisposing to ROP (P<0.05) were oxygen therapy, apnoea, ventilation, sepsis, anaemia, blood product transfusion, ventilation, shock requiring vasopressors and multiple gestation. Out of the 37 infants who developed ROP, 17 (48.5%) needed invasive management. CONCLUSION: Approximatel...
The British journal of ophthalmology, 2018
To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses. The TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%...
Acta paediatrica (Oslo, Norway : 1992), 2017
This study described the characteristics and risk factors of neonates who developed retinopathy of prematurity (ROP) and severe treatable ROP in two Egyptian neonatal intensive care units (NICUs). This retrospective cohort study comprised 108 preterm neonates who were screened for ROP after being admitted to the two NICUs run by Cairo University Hospital from June 2014 to May 2015. Patients were examined using digital fundus photography and indirect ophthalmoscopy was performed if ROP was detected. ROP occurred in 75 patients. Late-onset sepsis, ventilation, and hypercapnia were independently associated with ROP. Patients who developed severe treatable ROP had a younger gestational age than patients who did not develop ROP or developed mild or moderate ROP (29 weeks, range 27-33 weeks versus 32 weeks, range 28-36 weeks, p=0.002) and a lower birth weight (1,200g, range 980-1,590g versus 1,460g, range 770-2,475g, p=0.029). The risk factors associated with severe treatable ROP included...
The Most Important Factors for Retinopathy of Prematurity in Preterm Infants
Korean Journal of Perinatology, 2014
Purpose : There are many known risk factors for a retinopathy of prematurity (ROP). We analyzed the most important risk factors and predictors of ROP among them. Methods : We retrospectively reviewed the medical records of all premature infants admitted to the neonatal intensive care unit (NICU), between January 2010 and December 2012 at Gangnam CHA Medical Center, Seoul. . All infants (n=185) were hospitalized for more than 28 days, received eye examination for ROP and showed one of the following criteria: birth weight (BW) below 1,500 g, gestational age (GA) below 32 weeks, or oxygen treatment (≥40% oxygen for more than 3 days). We divided the infants into the Non-ROP group (n=162) and the ROP group (n=23, more than stage 1) and analyzed group comparisons, risk factors and the importance of each factor of ROP by SPSS 13.0. Results : Risk factors were duration of oxygen uses [Odds ratio (OR): 1.064, 95% confidence interval (CI): 1.007-1.125, P=0.028] and intravenous (IV) steroid (OR: 1.234, 95% CI: 1.000-1.523, P=0.049) by multifactor adjustment. The most important factor was oxygenation duration. The following factors were time to full enteral feedings, and IV steroid duration. Conclusion : The incidence of ROP will be decreased if we can reduce the length of oxygen uses, IV steroid use and advance the full feeding achievement.
Reduced incidence of retinopathy of prematurity
British Journal of Ophthalmology, 2001
Aim-To audit the prevalence of retinopathy of prematurity (ROP) in a level 2 status neonatal unit. Methods-Data were collected prospectively over 9 years from September 1989 to September 1998. Preterm infants were examined according to the Royal College of Ophthalmologists' guidelines and retinopathy graded following the International Classification of ROP. ROP 3-5 was analysed using logistic regression in relation to time, and to gestational age and birth weight. Results-383 babies were examined. Mean gestational age fell over the 9 year period (p=0.051) as did mean birth weight (p<0.001). There was a decrease in the number of infants with ROP grades 3-5 over the 9 years (p=0.045 and, when adjusted for gestational age and birth weight, the decrease in ROP 3-5 was significant (p=0.03). Conclusions-This study found a significant reduction in the incidence of ROP during the 9 years of the study period, despite a decrease in mean gestational age of and birth weight. The reduced incidence of ROP is attributed to improvements in ventilation techniques and overall care of the neonate, in particular the use of prenatal steroids and surfactant.
Journal of Medical Science And clinical Research, 2020
Background: Due to improved survival of Neonates, Incidence of Retinopathy of Prematurity (ROP) has also increased, which is a serious complication among premature neonates. It can lead to blindness unless recognized early. Aims & Objectives: To Estimate the proportion and various associated risk factors of Retinopathy of Prematurity among high risk neonates in the NICU. Materials and Methods: A Prospective Cohort Study was conducted enrolling all neonates admitted in NICU of a Tertiary Care Hospital from January 2018 to August 2018, with a gestational age <36 weeks and birth weight <1800 gms and Neonates with gestational age >36 weeks or birth weight >1800 gms who are exposed to oxygen were included. A total of 96 neonates underwent retinal evaluation by indirect ophthalmoscopy after Fourth postnatal week. Perinatal risk factors for Retinopathy of Prematurity were assessed using statistical analytical tests like Chi Square test and Mid P Exact test. Results: Out of 96 neonates, 13 neonates (13.54%) developed ROP; Among them 09 (69.23%) cases of stage 1, 1 (7.69%) case of stage 2, and 3 (23.07%) cases of stage 3. None of the neonates presented ROP at stages 4 or 5. Significant relationship was found between the occurrence of ROP and gestational age, oxygen therapy, blood transfusions, mode of oxygen delivery and sepsis. No association was found between the occurrence of ROP and gender, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, birth asphyxia, IUGR babies, intraventricular hemorrhage, meconium aspiration syndrome, phototherapy and duration of oxygentherapy. Conclusion: The incidence of ROP in this study was 13.54%; low gestational age, oxygen therapy, blood transfusion and mode of oxygen delivery and sepsis are significant risk factors for ROP occurrence.