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早产儿视网膜病变的发病率及危险因素:一项回顾性队列研究。

Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study.

作者信息

Freitas André Moraes, Mörschbächer Ricardo, Thorell Mariana R, Rhoden Ernani Luis

机构信息

1Universidade Federal de Ciências Da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS 90050-170 Brazil.

2Royal Liverpool University Hospital, Prescot St, Liverpool, L7 8XP UK.

出版信息

Int J Retina Vitreous. 2018 May 31;4:20. doi: 10.1186/s40942-018-0125-z. eCollection 2018.

Abstract

BACKGROUND AND OBJECTIVES

Advances in neonatal care promoted increased survival rates of preterm infants, with a consequent increase in the number of children affected by retinopathy of prematurity (ROP). This study estimates the incidence of ROP and evaluates potential risk factors associated.

METHODS

A retrospective cohort study of preterm infants born in a tertiary neonatal intensive care unit was conducted from March 2005 to August 2015. Six hundred and thirty-nine newborns were included based on the following criteria: infants born with less than 32 weeks' gestation or birth weight below 1500 g; or neonates born with 32-37 weeks' gestation or birth weight above 1500 g and any of the following associated: multiple gestation, respiratory distress syndrome, sepsis, blood transfusions or intraventricular hemorrhage. Neonates were followed up until disease resolution or until treatment criteria was achieved.

RESULTS

A total of 602 newborns were evaluated after applying the exclusion criteria. Mean gestational age was 30.7 ± 2.5 weeks. The incidences of ROP at any stage and of type 1 prethreshold ROP were 33.9 and 5.0% respectively. Logistic regression analysis revealed that risk factors associated with ROP at any stage were extremely low birth weight (ELBW) (odds ratio [OR] = 3.10; 95% confidence interval [95% CI]:1.73-5.55), pulmonary diseases (OR = 2.49; 95% CI: 1.35-4.59), intraventricular hemorrhage (OR = 2.17; 95% CI: 1.10-4.30), and low gestational age (OR = 0.81; 95% CI: 0.73-0.91). The main risk factors associated with type 1 prethreshold ROP were pulmonary diseases (OR = 9.58; 95% CI: 1.27-72.04) and ELBW (OR = 3.66; 95% CI: 1.67-8.00).

CONCLUSION

This study found a significant incidence of ROP (33.9%) in the studied population, and highlighted pulmonary diseases as a significant risk factor for type 1 prethreshold ROP.

摘要

背景与目的

新生儿护理的进步提高了早产儿的存活率,导致早产儿视网膜病变(ROP)患儿数量随之增加。本研究估计ROP的发病率,并评估相关的潜在风险因素。

方法

对2005年3月至2015年8月在一家三级新生儿重症监护病房出生的早产儿进行回顾性队列研究。根据以下标准纳入639例新生儿:孕周小于32周或出生体重低于1500克的婴儿;或孕周为32 - 37周或出生体重高于1500克且伴有以下任何一种情况的新生儿:多胎妊娠、呼吸窘迫综合征、败血症、输血或脑室内出血。对新生儿进行随访,直至疾病缓解或达到治疗标准。

结果

应用排除标准后,共评估了602例新生儿。平均孕周为30.7±2.5周。任何阶段ROP的发病率和1型阈值前ROP的发病率分别为33.9%和5.0%。逻辑回归分析显示,与任何阶段ROP相关的风险因素为极低出生体重(ELBW)(比值比[OR]=3.10;95%置信区间[95%CI]:1.73 - 5.55)、肺部疾病(OR=2.49;95%CI:1.35 - 4.59)、脑室内出血(OR=2.17;95%CI:1.10 - 4.30)和低孕周(OR=0.81;95%CI:0.73 - 0.91)。与1型阈值前ROP相关的主要风险因素为肺部疾病(OR=9.58;95%CI:1.27 - 72.04)和ELBW(OR=3.66;95%CI:1.67 - 8.00)。

结论

本研究发现研究人群中ROP的发病率较高(33.9%),并强调肺部疾病是1型阈值前ROP的重要风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/5984384/408886e1d4ca/40942_2018_125_Fig1_HTML.jpg

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