极低出生体重儿治疗性早产儿视网膜病变的发生风险。
Risk of development of treated retinopathy of prematurity in very low birth weight infants.
机构信息
North Carolina School of Science and Mathematics, Durham, NC, USA.
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2019 Nov;39(11):1562-1568. doi: 10.1038/s41372-019-0487-6. Epub 2019 Sep 6.
OBJECTIVE
Quantify the risk of treatment for retinopathy of prematurity (ROP) among infants meeting current U.S. screening guidelines.
STUDY DESIGN
Among infants ≤1500 g birth weight or ≤30 weeks gestation screened for ROP from 2006-2015, we developed a risk prediction model to identify infants treated for ROP. We applied our model to a separate infant cohort discharged in 2016.
RESULT
Seventy-five thousand eight hundred and twenty one infants met inclusion criteria; 2306 (3%) were treated for ROP. Infants with several risk factor combinations (no ventilator support or oxygen on postnatal day 28, no history of necrotizing enterocolitis, and no intraventricular hemorrhage) were at low risk of ROP. Applied to 6127 infants discharged in 2016, our model had 97.9% sensitivity, 63.3% specificity, positive predictive value of 4.0%, and negative predictive value of 99.9%.
CONCLUSION
Large numbers of infants at low risk of developing ROP are required to undergo screening. Refining current ROP guidelines may reduce unnecessary examinations.
目的
量化符合当前美国筛查指南的早产儿视网膜病变（ROP）治疗风险。
研究设计
在 2006 年至 2015 年间筛查出患有 ROP 的出生体重≤1500g 或胎龄≤30 周的婴儿中，我们开发了一种风险预测模型来识别接受 ROP 治疗的婴儿。我们将该模型应用于 2016 年出院的另一组婴儿。
结果
75821 名婴儿符合纳入标准；2306 名（3%）接受 ROP 治疗。有多种危险因素组合（出生后第 28 天无呼吸机支持或吸氧、无坏死性小肠结肠炎病史、无脑室出血）的婴儿 ROP 风险较低。将该模型应用于 2016 年出院的 6127 名婴儿，其敏感性为 97.9%，特异性为 63.3%，阳性预测值为 4.0%，阴性预测值为 99.9%。
结论
需要对大量低风险发生 ROP 的婴儿进行筛查。细化当前的 ROP 指南可能会减少不必要的检查。
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