Dos Santos Motta Mário Martins, Fortes Filho João Borges, Coblentz Jacqueline, Fiorot Claudia Amaral
Department of Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil.
Clin Ophthalmol. 2011;5:1783-7. doi: 10.2147/OPTH.S25431. Epub 2011 Dec 20.
The influence of multiple gestation on the occurrence of retinopathy of prematurity (ROP) is still not completely understood.
To verify the incidence of any stage of ROP and threshold ROP in singletons and in multiple gestation among preterm infants.
This was an institutional, prospective, and descriptive cohort study, which included preterm newborns with birth weight (BW) of 1500 g or less and/or gestational age (GA) of 32 weeks or less, as admitted to the neonatal units at Laranjeiras and Amparo Hospitals in Rio de Janeiro, Brazil, between January 2001 and July 2005, and whom remained hospitalized for at least 28 days. There were no exclusion criteria. Patients were divided into two groups: Group 1 included multiples; and Group 2 consisted of singletons.
A total of 159 infants that remained in neonatal unit care for at least 28 days were included in this study. Group 1 comprised 56 (35%) multiples; and Group 2 comprised 103 (65%) singletons. Mean BW was 1072 g ± 272 and 1089 g ± 282 in Groups 1 and 2, respectively (analysis of variance [ANOVA] P > 0.05). Mean GA among multiple gestation (Group 1) was 29 weeks ± 2.1; and 29 weeks ± 2.4 among singletons (Group 2) (ANOVA P > 0.05). Days in oxygen therapy ranged from 0 to 188 days. Median among Group 1 was 15 days, while median in Group 2 was 10 days (Kruskal-Wallis P > 0.05). Any stage ROP was detected in 66 (41.5%) of the whole cohort comprising 159 babies. Among the 56 multiples, 30 (53.6%) achieved any stage ROP, and among 103 singletons, 36 (35%) achieved any stage ROP (Chi-square test P < 0.05). Threshold ROP occurred in 12 (7.5%) of the 159 patients included. Three (5.3%) patients from Group 1 and nine (8.7%) patients in Group 2 reached threshold ROP needing laser treatment (Fisher's exact test P > 0.05).
This study showed higher frequency of any stage of ROP in twins and triplets but not regarding threshold disease. Because of the relatively small number of patients in this sample, other studies are necessary to determine if gemelarity plays a role in the occurrence of ROP.
多胎妊娠对早产儿视网膜病变（ROP）发生的影响仍未完全明确。
验证早产儿中单胎和多胎妊娠中任何阶段ROP及阈值ROP的发生率。
这是一项机构性、前瞻性和描述性队列研究，纳入了2001年1月至2005年7月间入住巴西里约热内卢拉兰热拉斯医院和安帕罗医院新生儿科、出生体重（BW）1500g及以下和/或胎龄（GA）32周及以下、且至少住院28天的早产儿。无排除标准。患者分为两组：第1组为多胎；第2组为单胎。
本研究共纳入159例至少在新生儿科护理28天的婴儿。第1组包括56例（35%）多胎；第2组包括103例（65%）单胎。第1组和第2组的平均BW分别为1072g±272和1089g±282（方差分析[ANOVA]P>0.05）。多胎妊娠（第1组）的平均GA为29周±2.1；单胎（第2组）为29周±2.4（ANOVA P>0.05）。吸氧治疗天数为0至188天。第1组中位数为15天，第2组中位数为10天（Kruskal-Wallis检验P>0.05）。在159例婴儿的整个队列中，66例（41.5%）检测到任何阶段的ROP。在56例多胎中，30例（53.6%）达到任何阶段的ROP，在103例单胎中，36例（35%）达到任何阶段的ROP（卡方检验P<0.05）。159例纳入患者中有12例（7.5%）发生阈值ROP。第1组3例（5.3%）患者和第2组9例（8.7%）患者达到需要激光治疗的阈值ROP（Fisher精确检验P>0.05）。
本研究显示双胞胎和三胞胎中任何阶段ROP的发生率较高，但阈值疾病方面并非如此。由于本样本中的患者数量相对较少，需要其他研究来确定双胎是否在ROP的发生中起作用。
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