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墨西哥克雷塔罗州一家社会保障地区医院1型和2型早产儿视网膜病变的发病率(2017 - 2018年)

Incidence of retinopathy of prematurity type 1 and type 2 in a regional Hospital of Social Security in the state of Queretaro, Mexico (2017-2018).

作者信息

Acevedo-Castellón Roger, Ramírez-Neria Paulina, García-Franco Renata

机构信息

Instituto Mexicano de Oftalmología IAP, Circuito de Estadio de Corregidora, sin número, Santiago de Querétaro, Querétaro, Mexico.

出版信息

BMC Ophthalmol. 2019 Apr 15;19(1):91. doi: 10.1186/s12886-019-1095-0.

Abstract

BACKGROUND

Retinopathy of prematurity (ROP), the primary cause of blindness in children, is a potential complication for 7.7% of live births in Mexico. Given that less than one-third of all neonatal intensive care units follow Mexican National ROP guidelines, there have been few reports regarding the incidences of types 1 and 2 ROP.

METHODS

This was a retrospective study that investigated the incidence and onset of ROP in a representative sample of children in Mexico. We analyzed the results obtained by the ROP Detection and Treatment Program, compliant with the Mexican National ROP guidelines, over a 1-year period. This study included 132 children who were born prematurely, were initially screened between October 2, 2017 and October 1, 2018, and underwent follow-up based on their risk group (in accordance with the Mexican National ROP guidelines).

RESULTS

The mean gestational age (GA) at birth was 32 weeks and 3 days (32w3d) (95% CI, ± 3 days), and the mean birth weight (BW) was 1594 g (95% CI, ± 96 g). The clinical features were as follows: 36.4% had immature retina without ROP, 22.0% had mild ROP, 5.3% had type 2 ROP, 27.3% had type 1 ROP, and 1.5% had advanced disease. Premature children with ROP requiring treatment (i.e., type 1 ROP + advanced ROP) were born at an MGA of 30w4d (95% CI, ± 5d; range, 26-35 weeks); their MBW was 1316 g (95% CI, ± 110 g; range, 830-2220 g). Diagnosis of ROP requiring treatment was made at a mean postmenstrual age (PMA) of 37w3d (95% CI, ± 5d; range, 31w1d to 42w1d).

CONCLUSION

In Mexico, screening and close ophthalmological follow-up of children who present with risk factors of birth weight < 1750 g and gestational age ≤ 34 weeks, both of which are observed more frequently in children with type 1 ROP, appears essential for implementing timely treatments (within 72 h). This is particularly important for children with PMA between 36 and 38 weeks, which is considered to be the peak age for disease stages that require timely intervention.

摘要

背景

早产儿视网膜病变(ROP)是儿童失明的主要原因,在墨西哥,ROP是7.7%活产儿的潜在并发症。鉴于所有新生儿重症监护病房中只有不到三分之一遵循墨西哥国家ROP指南,关于1型和2型ROP发病率的报告很少。

方法

这是一项回顾性研究,调查了墨西哥有代表性儿童样本中ROP的发病率和发病情况。我们分析了符合墨西哥国家ROP指南的ROP检测与治疗项目在1年期间获得的结果。本研究纳入了132名早产儿,他们于2017年10月2日至2018年10月1日期间首次接受筛查,并根据其风险组(按照墨西哥国家ROP指南)进行随访。

结果

出生时的平均胎龄(GA)为32周零3天(32w3d)(95%置信区间,±3天),平均出生体重(BW)为1594克(95%置信区间,±96克)。临床特征如下:36.4%视网膜未成熟且无ROP,22.0%患有轻度ROP,5.3%患有2型ROP,27.3%患有1型ROP,1.5%患有晚期疾病。需要治疗的ROP早产儿(即1型ROP + 晚期ROP)出生时的平均胎龄为30w4d(95%置信区间,±5天;范围为26 - 35周);其平均出生体重为1316克(95%置信区间,±110克;范围为830 - 2220克)。需要治疗的ROP诊断在平均孕龄(PMA)37w3d(95%置信区间,±5天;范围为31w1d至42w1d)时做出。

结论

在墨西哥,对出生体重<1750克和胎龄≤34周的有危险因素儿童进行筛查和密切的眼科随访,这两种情况在1型ROP儿童中更常见,对于及时实施治疗(72小时内)似乎至关重要。这对于孕龄在36至38周之间的儿童尤为重要,这被认为是需要及时干预的疾病阶段的高峰年龄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/6466710/0f075ee66dd0/12886_2019_1095_Fig1_HTML.jpg

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