早产儿视网膜病变的发生率和危险因素及治疗结果:一项回顾性队列研究

M. Deepak, S. Poonam, Jain Mayank, G. Aparna, M. Ap
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摘要

摘要目的:早产儿视网膜病变是一种发育中的视网膜疾病。早产儿的存活率增加,由于先进的新生儿护理,随之而来的早产儿视网膜病变病例的增加。本研究的目的是了解ROP的发生率及其危险因素和需要治疗的预后。方法:对2017年1月至2020年10月在三级重症监护病房出生的早产儿进行回顾性队列研究。203名新生儿根据以下标准入选:出生时胎龄(GA)≤35周,出生体重≤2000克,如果治疗儿科医生因新生儿重症监护病房的风暴病程建议进行ROP筛查,则GA bb≤35周,BW bb≤2000克。回顾资料以确定ROP的发生率和危险因素。对新生儿进行随访,直到疾病消退或达到治疗标准。结果:有203名婴儿参加了这项研究。男性125例(62.1%),女性77例(37.9%)。41例患儿出现ROP,发生率为20.2%。约一半的病例发生1期ROP(51.2%),其次是2期(24.4%)、APROP(22%)和3期(2.4%)。未发现4期和5期ROP病例。41例ROP中7例为1型,发生率为3.4%,均接受了治疗。ROP与PDA、败血症、PVL、BPD、RDS、产后类固醇、氧疗输血、TPN有显著相关性(P<0.05)。PIH、子痫前期、GDM、产前类固醇、IVH、多胎妊娠、SGA、NEC、有创和无创呼吸支持需求无显著相关性。结论:各阶段ROP发生率为20.2%,1型发病率为3.4%。ROP与PDA、败血症、PVL、BPD、RDS、产后类固醇、氧疗输血、TPN之间存在显著相关性。
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Incidence and risk factors predisposing to Retinopathy of prematurity and treatment outcome: A Retrospective cohort study
Abstract Purpose: Retinopathy of prematurity is a disorder of developing retina. The survival rate of preterm infants increased due to advance neonatal care, with a consequent increase in retinopathy of prematurity cases. The aim of our study was to access the incidence of ROP and its risk factors and outcome those who needed treatment. Methods: A retrospective cohort study of preterm infant born in tertiary intensive care unit was conducted from January 2017 to October 2020. 203 newborns were included based on the following criteria, Gestational Age (GA) at birth of ≤ 35 weeks, birth weight of ≤ 2000 gm and babies with GA>35 weeks and BW>2000 if the treating Paediatrician recommended ROP screening due to stormy course in NICU. Data were review to determine the incidence and risk factors of ROP. Neonates were followed up until diseases resolution or until treatment criteria were achieved. Results: Two hundred three babies were enrolled for the study. There were 125 (62.1%) males and 77 (37.9%) females. ROP was seen in 41 babies giving an incidence of 20.2%. About half of cases had stage 1 ROP (51.2%) followed by stage 2 (24.4%), APROP (22%) and stage 3 (2.4%). No case of stage 4 and stage 5 ROP were detected. 7 out of 41 ROP cases were type 1 disease with incidence of 3.4%, and received treatment. A significant association was noted between ROP and PDA, sepsis, PVL, BPD, RDS, Postnatal steroids, oxygen therapy blood transfusion, TPN (P<0.05). No significant association was found for PIH, Preeclampsia, GDM, receiving antenatal steroids, IVH, multiple gestations, SGA, NEC, invasive and non- invasive respiratory support need. Conclusion: This study found incidence of any stage of ROP was 20.2% and incidence of type 1 disease was 3.4%. A significant association was noted between ROP and PDA, sepsis, PVL, BPD, RDS, Postnatal steroids, oxygen therapy blood transfusion, TPN.
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