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孕周小于32周的足月儿早产儿视网膜病变的发病率及易患因素。

Incidence and factors predisposing to retinopathy of prematurity in inborn infants less than 32 weeks of gestation.

作者信息

Mitsiakos G, Papageorgiou A

机构信息

2 Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece.

Neonatal Department and Neonatal Intensive Care Unit (NICU), McGill University, Jewish General Hospital, Montreal, Quebec, Canada.

出版信息

Hippokratia. 2016 Apr-Jun;20(2):121-126.

Abstract

PURPOSE

Retinopathy of prematurity (ROP) is a visual-impairing disorder of the developing retinal vasculature in premature infants. Recent advances in neonatal care have led to an increase in the vulnerable premature population. The aim of this retrospective study was to assess the incidence of ROP and its risk factors according to degree of prematurity.

METHODS

Data from a sequence of 1,562 infants <32 weeks of gestational age, admitted to the Jewish General Hospital Neonatal Intensive Care Unit, a tertiary care perinatal center in Montreal, Canada, were reviewed to determine the incidence and risk factors of ROP. Perinatal risk factors for ROP were analyzed using univariate and multivariate analyses in four consecutive gestational age (GA) groups (24-25weeks, 26-27 weeks, 28-29 weeks and 30-31 weeks).

RESULTS

The overall incidence in our study was 15.6 %. Severe ROP, defined as stage 3 or plus disease was detected in 5.2 % of the neonates screened. In the univariate analyses, many risk factors in each GA group were found to have a significant association with ROP. On subsequent multivariate logistic regression analysis, birth weight, small for gestational age, the presence of patent ductus arteriosus (PDA), sepsis, necrotizing enterocolitis (NEC), and mechanical ventilation >7 days were independently associated with the development of ROP. Birth weight was consistently an independent risk factor for ROP in all GA groups.

CONCLUSION

Our study confirmed the importance of birth weight as an independent ROP risk factor. Sepsis, NEC, PDA, and prolonged mechanical ventilation have been shown to be independent risk factors in the different gestational age groups. Hippokratia 2016, 20(2): 121-126.

摘要

目的

早产儿视网膜病变(ROP)是一种影响早产儿视网膜血管发育的致盲性疾病。新生儿护理的最新进展导致了易患ROP的早产儿数量增加。这项回顾性研究的目的是根据早产程度评估ROP的发病率及其危险因素。

方法

回顾了加拿大蒙特利尔一家三级围产期中心——犹太总医院新生儿重症监护病房收治的1562例孕周小于32周婴儿的资料,以确定ROP的发病率和危险因素。在四个连续的孕周(GA)组(24 - 25周、26 - 27周、28 - 29周和30 - 31周)中,采用单因素和多因素分析方法分析ROP的围产期危险因素。

结果

我们研究中的总体发病率为15.6%。在接受筛查的新生儿中,5.2%被检测出患有严重ROP,即3期或附加病变。在单因素分析中,发现每个GA组中的许多危险因素与ROP有显著关联。在随后的多因素逻辑回归分析中,出生体重、小于胎龄儿、动脉导管未闭(PDA)、败血症、坏死性小肠结肠炎(NEC)以及机械通气超过7天与ROP的发生独立相关。出生体重在所有GA组中始终是ROP的独立危险因素。

结论

我们的研究证实了出生体重作为ROP独立危险因素的重要性。败血症、NEC、PDA和长时间机械通气已被证明是不同孕周组中的独立危险因素。《希波克拉底》2016年,20(2): 121 - 126。

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