1993年和1994年新南威尔士州出生时孕周小于32周婴儿的早产儿视网膜病变。

Retinopathy of prematurity in infants < 32 weeks' gestation at birth in New South Wales in 1993 and 1994.

作者信息

Todd D A, Cassell C, Kennedy J, John E

机构信息

Departments of Neonatology and,Ophthalmology,Westmead Hospital, Sydney, New South Wales, Australia.

出版信息

J Paediatr Child Health. 1999 Aug;35(4):355-357. doi: 10.1046/j.1440-1754.1999.00368.x.

DOI:10.1046/j.1440-1754.1999.00368.x

PMID:28871644

Abstract

OBJECTIVE

To study the incidence and severity of retinopathy of prematurity (ROP) in infants < 32 weeks' gestation.

DESIGN

Review of the records maintained in the New South Wales Neonatal Intensive Care Unit Study (NICUS) database on infants admitted to the neonatal intensive care units (NICU) in NSW from 1 January 1993 to 31 December 1994.

RESULTS

In the more premature infants, 23-26 weeks' gestation, 65% developed ROP (102 of 157 examined for ROP). Forty-four infants (28%) developed severe ROP (Stage ≥ 3 ROP), 19 infants (12.1%) required cryo/laser therapy and one infant (0.6%) in this group had a retinal detachment. One hundred and fifty-seven of 159 surviving infants (98.7%) were examined for ROP. In the infants 27-28 weeks' gestation, 38.3% developed ROP (103 of 269 examined for ROP). Fifteen infants (5.6%) developed severe ROP, seven infants (2.6%) required cryo/laser therapy for threshold ROP and three infants (1.1%) in this group had a retinal detachment. Two hundred and sixty-nine of 299 surviving infants (90%) were examined for ROP. In the infants 29-31 weeks' gestation, 10.8% developed ROP (48 of 443 examined for ROP). Six infants (1.4%) developed severe ROP, one infant (0.2%) required cryo/laser therapy for threshold ROP and no infant in this group had a retinal detachment. However, only 443 of 681 surviving infants (65.1%) in this group were examined for ROP. Of the four infants with detached retinas, one was a 25 week gestation infant weighing 840 g, two were 27 weeks' gestation weighing 960 and 980 g and one infant was a 28 week gestation infant weighing 620 g. No infant developed Stage 5 ROP.

CONCLUSION

In the more mature infants 29-31 weeks' gestation, the rate of ROP is low, although severe ROP still occurs. However, only 65.1% of these infants were examined for ROP and we should be diligent in screening for ROP in the sicker infants in this group. The incidence of severe ROP as well as the rate of cryo/laser therapy in premature infants 23-26 weeks' in NSW has not changed since the increases seen in the early 1990s. Retinal detachment also occurs in the infants 27-28 weeks' gestation and it is important that all these infants are screened for ROP.

摘要

目的

研究孕周小于32周的婴儿中早产儿视网膜病变（ROP）的发病率及严重程度。

设计

回顾新南威尔士州新生儿重症监护病房研究（NICUS）数据库中1993年1月1日至1994年12月31日期间入住新南威尔士州新生儿重症监护病房（NICU）的婴儿记录。

结果

在孕周为23 - 26周的更早产婴儿中，65%发生了ROP（157例接受ROP检查的婴儿中有102例）。44例婴儿（28%）发生了严重ROP（ROP分期≥3期），19例婴儿（12.1%）需要进行冷冻/激光治疗，该组中有1例婴儿（0.6%）发生了视网膜脱离。159例存活婴儿中有157例（98.7%）接受了ROP检查。在孕周为27 - 28周的婴儿中，38.3%发生了ROP（269例接受ROP检查的婴儿中有103例）。15例婴儿（5.6%）发生了严重ROP，7例婴儿（2.6%）因阈值ROP需要进行冷冻/激光治疗，该组中有3例婴儿（1.1%）发生了视网膜脱离。299例存活婴儿中有269例（90%）接受了ROP检查。在孕周为29 - 31周的婴儿中，10.8%发生了ROP（443例接受ROP检查的婴儿中有48例）。6例婴儿（1.4%）发生了严重ROP，1例婴儿（0.2%）因阈值ROP需要进行冷冻/激光治疗，该组中无婴儿发生视网膜脱离。然而，该组681例存活婴儿中只有443例（65.1%）接受了ROP检查。在4例视网膜脱离的婴儿中，1例是孕周25周、体重840克的婴儿，2例是孕周27周、体重分别为960克和980克的婴儿，1例是孕周28周、体重620克的婴儿。无婴儿发生5期ROP。

结论

在孕周为29 - 31周的较成熟婴儿中，ROP发生率较低，尽管仍会发生严重ROP。然而，这些婴儿中只有65.1%接受了ROP检查，我们应勤勉地对该组病情较重的婴儿进行ROP筛查。自20世纪90年代初ROP发生率上升以来，新南威尔士州孕周为23 - 26周的早产儿中严重ROP的发生率以及冷冻/激光治疗率并未改变。孕周为27 - 28周的婴儿也会发生视网膜脱离，对所有这些婴儿进行ROP筛查很重要。