Bonotto Ligia Beatriz, Moreira Ana Tereza Ramos, Carvalho Denise Siqueira
Setor de Ciências da Saúde, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Arq Bras Oftalmol. 2007 Jan-Feb;70(1):55-61. doi: 10.1590/s0004-27492007000100011.
To evaluate the prevalence of retinopathy of prematurity in premature babies examined at the "Hospital de Olhos Sadalla Amin Ghanem", coming from the "Maternidade Darcy Vargas" during the period from June 1992 to June 1999. To describe the risk factors that cause a predisposition to develop retinopathy of prematurity in the "Maternidade Darcy Vargas" and criteria to improve screening.
286 premature babies were selected in accordance with the predetermined criteria (gestation period less than 37 weeks, first examination at 4-12 week of age, minimum of 3 ophthalmic examinations before being 180 days old and registration at the "Hospital de Olhos Sadalla Amin"). An analysis of the total group of premature babies was carried out, being classified into Group 1 (without retinopathy of prematurity) and Group 2 (with retinopathy of prematurity) and the factors related to presence or not of retinopathy of prematurity in the premature babies were described. In order to evaluate the frequency of retinopathy of prematurity and factors associated with its occurrence, the Chi-Squared or the Fisher Exact tests were used. Margin of error 5%.
228 premature babies did not present sings of retinopathy of prematurity (group 1) and 58 presented signs (group 2). The prevalence of retinopathy of prematurity was 20%, 9% being in stage 1; 7% in stage 2; 4% in stage 3 and 1% in stage 4a. The most involved factors were: birth weight (p<0.0001), oxygen therapy (p<0.0000), birth age (p=0.0006), lung disease (p=0.0041), blood transfusion (p=0.0002), central nervous system alterations (p=0.0259), serious infections (p=0.0278) and Apgar less than 7 in the first minute (p=0.0442). The premature babies that most needed treatment weighed less than 1,399 g and were 33 weeks old.
According to the data the prevalence of retinopathy of prematurity was 20%. The premature babies' risks of retinopathy of prematurity were concentrated on weight below 1,400 g and age of 33 weeks. Bigger premature babies should be observed when one or more of the following factors are present: oxygen therapy, blood transfusion, lung disease, central nervous system alterations, serious infections and Apgar less than 7 in the first minute.
评估1992年6月至1999年6月期间在“萨达拉·阿明·加内姆眼科医院”接受检查的、来自“达西·瓦尔加斯妇产医院”的早产儿中早产儿视网膜病变的患病率。描述“达西·瓦尔加斯妇产医院”中导致早产儿易患早产儿视网膜病变的危险因素以及改进筛查的标准。
根据预定标准(妊娠期少于37周、4至12周龄时首次检查、180天前至少进行3次眼科检查并在“萨达拉·阿明·加内姆眼科医院”登记)选择286名早产儿。对整个早产儿组进行分析,分为第1组(无早产儿视网膜病变)和第2组(有早产儿视网膜病变),并描述与早产儿是否存在早产儿视网膜病变相关的因素。为了评估早产儿视网膜病变的发生率及其相关因素,使用卡方检验或费舍尔精确检验。误差幅度为5%。
228名早产儿未出现早产儿视网膜病变迹象(第1组),58名出现迹象(第2组)。早产儿视网膜病变的患病率为20%,其中1期为9%;2期为7%;3期为4%;4a期为1%。最相关的因素有:出生体重(p<0.0001)、氧疗(p<0.0000)、出生孕周(p=0.0006)、肺部疾病(p=0.0041)、输血(p=0.0002)、中枢神经系统改变(p=0.0259)、严重感染(p=0.0278)以及出生后第1分钟阿氏评分低于7分(p=0.0442)。最需要治疗的早产儿体重低于1399克且孕周为33周。
根据数据,早产儿视网膜病变的患病率为20%。早产儿患早产儿视网膜病变的风险集中在体重低于1400克和孕周为33周。当出现以下一个或多个因素时,对较大的早产儿也应进行观察:氧疗、输血、肺部疾病、中枢神经系统改变、严重感染以及出生后第1分钟阿氏评分低于7分。