Uchida Atsuro, Miwa Masayuki, Shinoda Hajime, Koto Takashi, Nagai Norihiro, Mochimaru Hiroshi, Tomita Yohei, Sasaki Mariko, Ikeda Kazushige, Tsubota Kazuo, Ozawa Yoko
Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
J Ophthalmol. 2014;2014:187929. doi: 10.1155/2014/187929. Epub 2014 Apr 30.
Aim. To find predictive and indicative markers of risk for development of retinopathy of prematurity (ROP) and its progression to the stage requiring laser treatment, in premature infants whose gestational age (GA) was under 33 weeks. Methods. We retrospectively reviewed medical records of 197 premature infants born in 2005-2010 whose GA < 33 weeks and underwent eye screening at Keio University Hospital. The association between candidate risk factors and development or progression of ROP was assessed. Results. Among the 182 eligible infants (median GA, 29.1 weeks; median birth weight (BW), 1028 g), 84 (46%) developed any stage of ROP, of which 45 (25%) required laser treatment. Multivariate analysis using a stepwise method showed that GA (P = 0.002; 95% confidence interval (CI), 0.508-0.858), BW (P < 0.001; 95% CI, 0.994-0.998), and lower maternal age (P = 0.032; 95% CI, 0.819-0.991) were the risk factors for ROP development and GA (P < 0.001; 95% CI, 0.387-0.609) and lower maternal age (P = 0.012; 95% CI, 0.795-0.973) were for laser treatment. The odds ratio of requiring laser treatment was 3.3 when the maternal age was <33 years. Conclusion. ROP was more likely to be developed and progressed in infants born from younger mother and low GA.
目的。在胎龄（GA）小于33周的早产儿中，寻找早产儿视网膜病变（ROP）发生及其进展至需要激光治疗阶段的预测性和指示性标志物。方法。我们回顾性分析了2005年至2010年在庆应义塾大学医院出生、GA<33周且接受眼部筛查的197例早产儿的病历。评估候选危险因素与ROP发生或进展之间的关联。结果。在182例符合条件的婴儿中（中位GA，29.1周；中位出生体重（BW），1028g），84例（46%）发生了任何阶段的ROP，其中45例（25%）需要激光治疗。采用逐步法进行的多变量分析显示，GA（P = 0.002；95%置信区间（CI），0.508 - 0.858）、BW（P < 0.001；95% CI，0.994 - 0.998）和较低的母亲年龄（P = 0.032；95% CI，0.819 - 0.991）是ROP发生的危险因素，而GA（P < 0.001；95% CI，0.387 - 0.609）和较低的母亲年龄（P = 0.012；95% CI，0.795 - 0.973）是需要激光治疗的危险因素。母亲年龄<33岁时，需要激光治疗的比值比为3.3。结论。母亲年龄较小且GA较低的婴儿发生ROP及其进展的可能性更大。
