Incidence and Risk Factors for Retinopathy of Prematurity in Multiple Gestations

Abstract

To determine the incidence and risk factors of retinopathy of prematurity (ROP) among new-born Chinese infants of multiple gestations.A retrospective review of medical records was performed for all neonates of multiple gestations screened for ROP between January 2007 and December 2012 in 2 neonatal intensive care units in Hong Kong. Screening was offered to very low birth weight (VLBW; ≤1500 g) and/or preterm (gestation ≤32 weeks) neonates using the Royal College of Ophthalmologists ROP guideline and the International Classification of ROP by 3 pediatric ophthalmologists. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.A total of 153 Chinese infants of multiple gestations were included in the study. The mean gestational age (GA) was 30.8 ± 2.4 weeks and the mean birth weight (BW) was 1284.8 ± 267.4 g. The incidence of ROP and Type 1 ROP was 11.8% and 3.9%, respectively. On univariate analysis, younger GA, lighter birth weight, postnatal hypotension, inotropes use, bronchopulmonary disease, and intraventricular hemorrhage were common independent risk factors for the development of ROP and Type 1 ROP (all P ≤ 0.04). On multivariate analysis, younger GA, surfactant use, invasive mechanical ventilation, higher mean oxygen concentration, thrombocytopenia, intraventricular hemorrahage, total parental nutrition, and hypoglycemia were significant risk factors for ROP. For Type 1 ROP, there were no significant dependent risk factors.In preterm Chinese infants born from multiple gestations, prematurity, lighter weight, postnatal hypotension, inotropes use, bronchopulmonary dysplasia, and an intraventricular hemorrhage were common independent risk factors for the development of ROP and Type 1 ROP.

Retinopathy of Prematurity Among Very Low-Birth-Weight Infants in China: Incidence and Perinatal Risk Factors

“…In our study, the incidence of ROP among VLBW infants with GA < 32 weeks was 30.5%, similar to the incidence reported in Saudi Arabia (37.4%) by Binkhathlan et al 13 The incidence of stage ‡3 ROP in our study was 3.2%, significantly higher in infants delivered at <32 weeks or with BW < 1000 g and consistent with the findings of other Chinese studies. 14,15 Moreover, no infant had stage 4 or stage 5 ROP in our study. With the increased awareness of the risk of blindness caused by ROP, the Chinese Ministry of Health guidelines for the prevention and treatment of ROP were published in 2004.…”

“…After adjusting for confounding factors, IVF increased the risk of ROP by approximately two times, consistent with some domestic and international studies. 14,18 Watts and Adams 18 showed that assisted conception using IVF rather than gonadotrophin stimulation appears to be the major risk factor for the development of threshold ROP. Yau et al 14 also found that IVF was an independent risk factor for type 1 ROP (OR ¼ 6.17; 95% CI 1.15-45.83).…”

Teamwork en medicina: una necesidad

“…Los recién nacidos que presentaron retinopatía de la prematuridad fueron 48 (25,26%), siendo la edad gestacional menor de 28 semanas al nacer y el peso menor a 1.000 gramos; antecedentes similares reportados por Port y Yau (18,19) . En el estudio realizado por Fernández R, se reportó 30,8% para los menores de 1.500 gramos al nacer (20) .…”

Recognition and Prevention of Visual Loss Due to Retinopathy of Prematurity in High Risk Twin Infant Pairs: A Case Series with a Multi-specialty Approach

“…Known risk factors include small gestational age (GA) [4], anemia, blood transfusion, mechanical ventilation [5], hypoxemia [6], perinatal sepsis [7], use of inotropes [8], intra-ventricular hemorrhage (IVH), low birth weight [9], and postnatal exposures [10]. Limited literature is available regarding ROP development among twin pairs [11]. Our study aims to determine profile of asymmetry of ROP among twins the newer post natal risk factors and effects of current treatment responsible for the variability in ROP.…”