Fortes Filho João Borges, Valiatti Fabiana Borba, Eckert Gabriela Unchalo, Costa Marlene Coelho da, Silveira Rita C, Procianoy Renato Soibelmann
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
J Pediatr (Rio J). 2009 Jan-Feb;85(1):48-54. doi: 10.2223/JPED.1870.
To analyze prevalence and risk factors for retinopathy of prematurity (ROP) among preterm infants born small for gestational age (SGA) and appropriate for gestational age (AGA).
A prospective cohort study included preterm infants with birth weight (BW) < or = 1,500 grams and gestational age (GA) < or = 32 weeks, divided into two groups: AGA or SGA. Prevalences and risk factors for ROP were determined in both groups. Logistic regression was used for the significant variables after univariate analysis.
A total of 345 patients were examined: 199 included in the AGA group and 146 in the SGA. Mean BW and GA in the whole cohort (345 patients) were 1,128.12 grams (+/-239.9) and 29.7 weeks (+/-1.9), respectively. The prevalence of any stage ROP and severe ROP (needing treatment) was 29.6 and 7.0%, respectively. ROP in any evolutive stage developed in 66 AGA (33.2%) and in 36 SGA (24.7%) (p = 0.111). Severe ROP occurred in 15 AGA (7.5%) and in nine SGA (6.2%) (p = 0.779). After adjusted logistic regression, weight gain from birth to sixth week of life and need for blood transfusions were found to be significant risk factors for ROP in both groups.
This study has shown that being SGA was not a significant risk factor for any stage ROP or for severe ROP in this cohort and, also, that the risk factors for ROP were similar among SGA and AGA very-low-birth-weight preterm babies.
分析小于胎龄儿(SGA)和适于胎龄儿(AGA)早产婴儿中早产儿视网膜病变(ROP)的患病率及危险因素。
一项前瞻性队列研究纳入了出生体重(BW)≤1500克且胎龄(GA)≤32周的早产婴儿,分为两组:AGA组或SGA组。确定两组中ROP的患病率及危险因素。单因素分析后,对有统计学意义的变量进行逻辑回归分析。
共检查了345例患者:AGA组199例,SGA组146例。整个队列(345例患者)的平均BW和GA分别为1128.12克(±239.9)和29.7周(±1.9)。任何阶段ROP和重度ROP(需要治疗)的患病率分别为29.6%和7.0%。66例AGA(33.2%)和36例SGA(24.7%)出现了任何进展期ROP(p = 0.111)。15例AGA(7.5%)和9例SGA(6.2%)发生了重度ROP(p = 0.779)。经校正的逻辑回归分析后发现,两组中出生至生后第6周的体重增加和输血需求是ROP的显著危险因素。
本研究表明,在该队列中,SGA并非任何阶段ROP或重度ROP的显著危险因素,而且,SGA和AGA极低出生体重早产婴儿中ROP的危险因素相似。