Huang Hai-Bo, Chen Yi-Hua, Wu Jing, Hicks Matt, Yi Yan-Zhi, Zhang Qian-Shen, Chow Chun-Bong, Cheung Po-Yin
Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Department of Ophthalmology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Front Pediatr. 2020 Oct 15;8:553519. doi: 10.3389/fped.2020.553519. eCollection 2020.
To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in very and extremely preterm (28- <32, and <28 weeks gestation, respectively) neonates, and the predictive factors for ROP in the early hours after birth and during hospitalization. Using a prospective database supplemented with a retrospective chart review, we identified preterm neonates born at gestation <32 weeks at the University of Hong Kong-Shenzhen Hospital between January 2015 and August 2018. Demographic and clinical variables were studied including indicators of disease acuity in the first 24 h after birth. We also compared the difference in risk factors between survivors with ROP and survivors without ROP. During the study period, there were 529 preterm neonates admitted to our neonatal intensive care unit with 120 (23%) born at <32 weeks' gestation. Thirteen (11%) neonates died. Among the 107 survivors, 23 (21%) had ROP, of whom five (22%) received laser and/or medical therapy for severe ROP. Compared with survivors without ROP, infants with ROP had lower mean blood pressure in the first 12 and 24 h after birth, respectively. Using multivariate regression, gestation age, mean blood pressure in the first 12 h after birth, hospital length of stay, and total days of blood gases pH <7.2 were independent risk factors for ROP. In this small cohort of Chinese neonates born <32 weeks' gestation, survivors with ROP had a lower blood pressure in the early hours after birth, younger gestation, longer hospital stay, and duration of acidosis when compared to those without ROP.
为研究极早产儿（分别为孕28 - ＜32周和＜28周）视网膜病变（ROP）的发病率及危险因素，以及出生后早期及住院期间ROP的预测因素。通过前瞻性数据库并辅以回顾性病历审查，我们确定了2015年1月至2018年8月在香港大学深圳医院出生的孕周＜32周的早产儿。研究了人口统计学和临床变量，包括出生后最初24小时内的疾病严重程度指标。我们还比较了ROP幸存者和无ROP幸存者之间危险因素的差异。在研究期间，有529名早产儿入住我们的新生儿重症监护病房，其中120名（23%）出生时孕周＜32周。13名（11%）新生儿死亡。在107名幸存者中，23名（21%）患有ROP，其中5名（22%）因严重ROP接受了激光和/或药物治疗。与无ROP的幸存者相比，患有ROP的婴儿在出生后的前12小时和24小时平均血压较低。通过多因素回归分析，胎龄、出生后前12小时的平均血压、住院时间以及血气pH＜7.2的总天数是ROP的独立危险因素。在这个孕周＜32周的中国新生儿小队列中，与无ROP的新生儿相比，患有ROP的幸存者在出生后早期血压较低、胎龄较小、住院时间较长且酸中毒持续时间较长。
