A Retrospective Study Of Risk Factors Of Retinopathy Of Prematurity In Preterm Neonates (A Six Year Study In A Single Center NICU)

Background:The aim of this study was to identify predictors of severe retinopathy of prematurity (ROP) in tertiary hospital of east china and to investigate the incidence and risk factors of retinopathy of prematurity in the neonatal intensive care unit, which may provide evidence useful in the prevention and treatment of ROP.Material/Methods:This was a retrospective case control study which was performed at Zhong Da Hospital, Nanjing, from January 2009 to December 2014.Total 2216 infants undergoing ophthalmologic examination, in which 274 cases had inadequate data and 738 cases had repeated ROP screening. Finally,1204 cases were recruited in which ROP was detected in 59 infants,59 infants with ROP and matched 236 infants without ROP were included in our study. Pre-natal and perinatal information of infants was reviewed, and risk factors were determined. Conditional logistic regression model was used to analyze the univariate and multivariate data to estimate the odds ratio (OR) and the 95% confidence interval (95% CI).Result:Among 1204 infants underwent ophthalmologic examination, ROP was detected in 59 infants,59 infants with ROP and matched 236 infants without ROP were included in our study, incidence of ROP was 4.90%. According to the distribution of cases among gestational age<29 week,29-32 week and>32 week overall incidence was found 47.5%,10.4% and 1.9% respectively. Whereas, according to birthweight<1250 g,1251-1500 g,1501-2000 g and>2001 overall incidence was found 33.93%,14.88%,2.81% and 1.67% respectively. None of the patients developed stage 5 ROP. Concerning the zone of ROP,8 patients (13.6%) had zonel ROP,4 patients (6.8%) had zone 2 ROP, and 47 patients (79.7%) had zone3 ROP Among the 32 risk factors were analyzed in univariate analysis in occurrence of ROP, we found low birth weight, gestational age, oxygen, mechanical ventilator, CPAP, blood transfusion, BE, hypo-albumin, intra cranial hemorrhage, congenital heart disease, neonatal jaundice, birth asphyxia and twin pregnancy were associated with ROP. After multivariate analysis, we found low birth weight (p=0.047), gestational age (p=0.040) and CPAP (0.010) as independent risk factors of ROP.Conclusion:This study suggest that low birth weight, low gestational age and use of CPAP is independently associated with a significantly increased risk of ROP. Therefore, advance management of mechanical ventilation or CPAP is needed in premature infants to decrease incidence of ROP.