极早产儿是否需要在 31 孕周前进行早产儿视网膜病变筛查？
Do extremely preterm infants need retinopathy of prematurity screening earlier than 31 weeks postmenstrual age?
机构信息
Pediatrics/Neonatology, Thomas Jefferson University/Nemours, Philadelphia, PA, USA.
Pediatrics/Neonatology, Christiana Care Health System, Newark, DE, USA.
出版信息
J Perinatol. 2021 Feb;41(2):305-309. doi: 10.1038/s41372-020-0681-6. Epub 2020 May 6.
OBJECTIVE
To evaluate the utility of screening all extremely preterm infants for retinopathy of prematurity (ROP) at 4 weeks chronologic age, which is earlier than recommended by the 2018 AAP guidelines.
STUDY DESIGN
Retrospective analysis of infants <27 weeks gestation from two tertiary NICUs between 2006 and 2018 who survived until first eye examination.
RESULTS
550 infants (gestational age 25.1 ± 1.2 weeks and birth weight 758 ± 323 g) had 1310 examinations performed by 32 weeks postmenstrual age (PMA), and 676 (51.6%) of these were prior to 31 weeks PMA. No examinations in infants prior to 31 weeks PMA met the criteria for laser therapy. Of 87/550 infants (15.8%) who required laser therapy, none did so prior to 32 weeks PMA.
CONCLUSIONS
No infants born <27 weeks gestation were found to have severe ROP prior to 31 weeks PMA, supporting the most recent AAP recommendation of initiating ROP screening at 31 weeks PMA for extremely preterm infants.
目的
评估在 4 周龄（早于 2018 年 AAP 指南建议的时间）对所有极早产儿进行早产儿视网膜病变（ROP）筛查的效用。
研究设计
对 2006 年至 2018 年间两家三级 NICU 中存活至首次眼部检查的<27 周龄婴儿进行回顾性分析。
结果
550 名婴儿（胎龄 25.1±1.2 周，出生体重 758±323 克）进行了 1310 次检查，达到 32 周校正胎龄（PMA），其中 676 次（51.6%）发生在 31 周 PMA 之前。在 31 周 PMA 之前进行的婴儿检查中，没有任何检查符合激光治疗标准。在需要激光治疗的 87/550 名婴儿（15.8%）中，无一例在 32 周 PMA 之前进行激光治疗。
结论
未发现胎龄<27 周的婴儿在 31 周 PMA 之前发生严重 ROP，支持最近 AAP 建议对极早产儿在 31 周 PMA 开始进行 ROP 筛查。
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