Incidence of retinopathy of prematurity and risk factors in the South-Western Region of Iran

Yadav

J. Kathmandu Med. Coll.

et al. 2017

Background: Retinopathy of prematurity is a vascular retinal disease that can cause blindness in premature new born babies. Several risk factors are associated with the incidence of ROP. Information and data on risk factors associated with ROP in context to Nepalese population is scarcely documented in literature. Objectives: The purpose of this study was to evaluate the risk factors of retinopathy of prematurity in premature infants admitted in the neonatal intensive care unit of Tribhuvan University Teaching Hospital. Methods: Neonates with gestational age of 36 weeks or less and birth weight of 2000 gram or less admitted to neonatal intensive care unit (NICU), during 2013 to 2015 were screened for retinopathy of prematurity. Risk factors and severity of retinopathy of prematurity were evaluated. The initial examination was carried out at 4-6 weeks after birth by indirect ophthalmoscope and retinopathy of prematurity positive and negative infants were compared subsequently. The Chisquare and independent t-tests were used for statistical analysis. A p value less than 0.05 was considered statistically signifi cant. Results: The incidence of retinopathy of prematurity was 22.6% and severe retinopathy of prematurity requiring treatment was observed in 3.2% of 93 neonates who had eye examinations. There was a signifi cant relationship between the occurrence of ROP and birth weight (p=0.000), gestational age (p=0.000), duration of oxygen therapy (p=0.009) and sepsis (p=0.002). However, insignifi cant relationship was observed between the occurrence of retinopathy of prematurity and gender, type of delivery, multiple gestation, premature rupture of foetal membrane, respiratory distress syndrome and hyperbilirubinaemia. Conclusion: The risk factors contributing to development of retinopathy of prematurity showed signifi cant relationship with immaturity, duration of oxygen supplementation and septicaemia.

Section: Discussionsupporting

confidence: 79%

Risk factors associated with retinopathy of prematurity among neonates in a tertiary care hospital in Nepal

Yadav

J. Kathmandu Med. Coll.

et al. 2017

“…Measures of morbidity used particularly in community based studies included; need for hospitalisation and prevalence of wheezing and pneumonia [ 23 ], number of routine and additional clinic visits in the post natal period [ 19 ] or a pictorial diary with specific measurements of diarrhoea and ways of measuring body temperature and respiratory rate [ 17 ]. Studies with an emphasis on facility based care used proxy measures for morbidity such as need for transfer to NICU [ 49 ], length of time in NICU [ 70 , 71 , 72 ] time spent in oxygen [ 73 ] and time spent on ventilator [ 41 , 74 – 76 ], number of routine and additional clinic visits in the post natal period [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…The majority of these facility based studies report an increased risk of morbidity in preterm infants compared to babies born at term. This includes increased risk of respiratory distress syndrome (RDS) [ 52 , 59 , 102 , 103 ], broncho-pulmonary dysplasia (BPD) [ 68 , 97 , 104 – 108 ], retinopathy of prematurity (ROP) [ 73 , 101 , 106 , 109 ] intraventricular haemorrhage (IVH) [ 72 , 110 ], periventricular leukomalacia (PVL) [ 111 ] and cerebral palsy [ 55 , 58 , 112 ]. Studies are however not comparable due to differences in diagnostic approach and level of care available in the different settings.…”

Section: Resultsmentioning

confidence: 99%

Survival, Morbidity, Growth and Developmental Delay for Babies Born Preterm in Low and Middle Income Countries – A Systematic Review of Outcomes Measured

2015

BackgroundPremature birth is the leading cause of neonatal death and second leading in children under 5. Information on outcomes of preterm babies surviving the early neonatal period is sparse although it is considered a major determinant of immediate and long-term morbidity.MethodsSystematic review of studies reporting outcomes for preterm babies in low and middle income settings was conducted using electronic databases, citation tracking, expert recommendations and “grey literature”. Reviewers screened titles, abstracts and articles. Data was extracted using inclusion and exclusion criteria, study site and facilities, assessment methods and outcomes of mortality, morbidity, growth and development. The Child Health Epidemiology Reference Group criteria (CHERG) were used to assess quality.FindingsOf 197 eligible publications, few (10.7%) were high quality (CHERG). The majority (83.3%) report on the outcome of a sample of preterm babies at time of birth or admission. Only 16.0% studies report population-based data using standardised mortality definitions. In 50.5% of studies, gestational age assessment method was unclear. Only 15.8% followed-up infants for 2 years or more. Growth was reported using standardised definitions but recommended morbidity definitions were rarely used. The criteria for assessment of neurodevelopmental outcomes was variable with few standardised tools - Bayley II was used in approximately 33% of studies, few studies undertook sensory assessments.ConclusionsTo determine the relative contribution of preterm birth to the burden of disease in children and to inform the planning of healthcare interventions to address this burden, a renewed understanding of the assessment and documentation of outcomes for babies born preterm is needed. More studies assessing outcomes for preterm babies who survive the immediate newborn period are needed. More consistent use of data is vital with clear and aligned definitions of health outcomes in newborn (preterm or term) and intervention packages aimed to save lives and improve health.

“…[23456789] The third important risk factor in our study is prolonged oxygen exposure by invasive or noninvasive ventilation, and by nasal cannula, that was proportionately increasing the risk of ROP occurrence. The premature neonate is developmentally unprepared to the oxygen-rich extrauterine life because of an impaired antioxidant defense system.…”

Section: Discussionmentioning

confidence: 87%

Retinopathy of prematurity: Revisiting incidence and risk factors from Oman compared to other countries

et al. 2017

Purpose:The purpose of this study is to determine the incidence of retinopathy of prematurity (ROP) and the maternal/neonatal risk factors at a tertiary care hospital in Oman, compared to other countries.Patients and Methods:A retrospective analysis of premature neonates born with gestational age (GA) 24–32 weeks at Sultan Qaboos University Hospital, Oman, from January 2007 to December 2010. Maternal and neonatal in-hospital course was retrieved. The incidence of ROP was reported. Risk factors analyses were performed using univariate and multivariate statistics.Results:A total of 171 neonates (57% males, 43% females) were included for analysis. The incidence of ROP (any stage) was 69/171 (40.4%). Infants with ROP had significantly lower GA (27.7±2 weeks) compared to non-ROP group (30.2±1.7 weeks), P < 0.001),P < 0.001) and significantly lower birth weight (BW) (948 ± 242 g in ROP group vs. 1348 ± 283 g in non-ROP group;P < 0.001). Other significant risk factors associated with ROP were: small for GA, respiratory distress syndrome, requirement for ventilation, duration of ventilation or oxygen therapy, bronchopulmonary dysplasia, hyperglycemia, late onset sepsis (clinical or proven), necrotizing enterocolitis, patent ductus arteriosus, seizures, and number of blood transfusions. There was no significant difference in maternal characteristics between the ROP and non-ROP groups except that mothers of infants with ROP were found to be significantly younger. Logistic regression analysis revealed early GA, low BW, duration of Oxygen therapy, and late-onset clinical or proven sepsis as independent risk factors.Conclusion:ROP is still commonly encountered in neonatal practice in Oman and other countries. Early GA, low BW, and prolonged oxygen therapy continue to be the main risk factors associated with the occurrence of ROP in our setting. In addition, an important preventable risk factor identified in our cohort includes clinical or proven late-onset sepsis.