Risk Factors for Acute Retinopathy of Prematurity

Abstract

We prospectively studied the risk factors and the incidence of retinopathy of prematurity (ROP) in 195 consecutive preterm infants. Birth weight and duration of mechanical ventilation were the only factors that were significantly associated with the incidence of ROP. While indomethacin increases the risk of developing ROP, maternal antenatal steroids have a protective effect against the development of severe stages of ROP. The presence of intraventricular hemorrhage increases the risk of severe ROP.

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

“…Most studies have demonstrated that prematurity and low BW are the strongest predictive factors of ROP ( 19 – 21 ). Other factors associated with ROP include prolonged mechanical ventilation ( 22 – 24 ), the need for nasal CPAP ( 25 , 26 ), development of BPD ( 27 , 28 ), sepsis ( 29 ), hyperoxia ( 30 ), hypoxia ( 31 ), hypercapnia, and acidosis. Higher rates of ROP were found in infants with longer length of initial hospital stay ( 32 , 33 ), and prolonged parenteral nutrition, which are a proxy for cumulative illness burden.…”

Retinopathy of prematurity: a review of risk factors and their clinical significance

“…10,13,39,57,71,74,109,114,131,149,152,167,231,236,257,264,276,283,312,313,315,364,401,412,428 Similarly, many studies identified prolonged mechanical ventilation as a risk factor for any or severe ROP. 11,12,36,39,53,57,106,120,157,167,187,211,232,263,266,274,275,286,335,337,345,348,368,370,405,406,412,417…”

“…Prolonged mechanical ventilation (PMA), often defined as >7 days of ventilator dependence, is among the most frequently identified risk factors for ROP. 12,24,26,35,54,106,117,120,137,148,157,174,184,187,211,220,233,254,257,263,266,286,345,348,370,397,405,412,413,417 A recent cohort study including 979 infants revealed that the need for respiratory support including mechanical ventilation and high-frequency oscillatory ventilation at time of first study-related examination (median 33 weeks PMA) was an independent risk factor for referral-warranted ROP. 417 Several studies have found that, like traditional mechanical ventilation, the need for nasal CPAP also increases the risk of ROP, 150,174,220,233,275,337,363 and delays involution of ROP.…”

“…Management of PDA, which is still controversial, includes cyclooxygenase inhibitors and surgical closure, both of which have been associated with ROP. 12,94,122,191,195,260 Jegatheesan and coworkers 191 conducted a randomized controlled trial, and found that administration of high dose indomethacin was independently associated with severe ROP. Analysis of Canadian Neonatal Network data revealed surgical ligation was associated with higher frequency of severe ROP compared with infants who received indomethacin; 260 however, other studies revealed no effects for surgical ligation on ROP.…”

“…269 IVH occurs in 25–30% of all preterm infants <1,500 g. 344 For unclear reasons, IVH has repeatedly been associated with ROP and appears in many of the articles reviewed. 12,14,23,35,58,68,76,122,174,220,235,266,272,311,336,337,387,395,398,405,414,415 An epidemiologic analysis of 2,950 infants in Turkey revealed that any IVH was associated with greater risk of ROP. 23…”