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母亲种族、胎龄、出生体重、体重增加与早产儿重度视网膜病变的关系。

Relationships between maternal ethnicity, gestational age, birth weight, weight gain, and severe retinopathy of prematurity.

机构信息

Center for Pediatrics, Barts and the London School of Medicine and Dentistry, Queen Mary College, London, United Kingdom.

出版信息

J Pediatr. 2013 Jul;163(1):67-72. doi: 10.1016/j.jpeds.2012.12.038. Epub 2013 Jan 23.

DOI:10.1016/j.jpeds.2012.12.038
PMID:23351601
Abstract

OBJECTIVE

To develop an algorithm that allows advanced identification of infants requiring treatment for retinopathy of prematurity (ROP).

STUDY DESIGN

A retrospective observational study was performed at 2 tertiary neonatal units serving a multiethnic population in the UK, using data on 929 infants eligible for ROP screening. The relationships between study variables and the risk of developing ROP requiring treatment were analyzed using multiple logistic regression.

RESULTS

After applying exclusion criteria, data from 589 infants were analyzed; of these, 57 required laser treatment. The proportion of treated infants was 5.9% of those born to black mothers, 9.39% of those born to white mothers, and 12.8% of those born to Asian mothers (P = .047). Multiple logistic regression showed that gestational age, birth weight, maternal ethnicity, and early weight gain were predictors for the development of ROP requiring treatment, with maternal ethnicity having greater predictive power compared with early weight gain. We developed an algorithm for predicting the development of ROP requiring treatment with sensitivity, specificity, and positive and negative predictive values of 100%, 65.7%, 23.8%, and 100%, respectively.

CONCLUSION

Gestational age, birth weight, early weight gain, and maternal ethnicity are important predictors for the development of ROP requiring treatment. In a multiethnic population, an algorithm to predict development of ROP requiring treatment should include maternal ethnicity. If confirmed through prospective studies, this algorithm could reduce the number of opthalmologic examinations performed for ROP screening.

摘要

目的

开发一种算法,以实现对早产儿视网膜病变(ROP)需治疗病例的早期识别。

研究设计

在英国两家为多民族服务的三级新生儿病房进行了一项回顾性观察性研究,使用了 929 名符合 ROP 筛查条件的婴儿的数据。采用多因素逻辑回归分析了研究变量与 ROP 需治疗风险之间的关系。

结果

在应用排除标准后,对 589 名婴儿的数据进行了分析,其中 57 名婴儿需要激光治疗。黑人母亲所生婴儿中需治疗的比例为 5.9%,白人母亲所生婴儿中为 9.39%,亚洲母亲所生婴儿中为 12.8%(P =.047)。多因素逻辑回归显示,胎龄、出生体重、母亲种族和早期体重增加是 ROP 需治疗的预测因素,而与早期体重增加相比,母亲种族具有更强的预测能力。我们开发了一种预测 ROP 需治疗的算法,其敏感性、特异性、阳性预测值和阴性预测值分别为 100%、65.7%、23.8%和 100%。

结论

胎龄、出生体重、早期体重增加和母亲种族是 ROP 需治疗的重要预测因素。在多民族人群中,预测 ROP 需治疗的算法应包括母亲种族。如果通过前瞻性研究得到证实,该算法可减少 ROP 筛查所需的眼科检查次数。

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