意大利早产儿队列中早产儿视网膜病变的发生率及危险因素。
Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants.
机构信息
Division of Neonatology, Careggi University Hospital, Largo Brambilla 3, 50141, Florence, Italy.
Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.
出版信息
Ital J Pediatr. 2021 Mar 12;47(1):64. doi: 10.1186/s13052-021-01011-w.
OBJECTIVE
Non-negligible differences in retinopathy of prematurity (ROP) and its risk factors between different neonatal intensive care units (NICUs) are reported. Our aim was to assess the incidence and risk factors for ROP development in a large cohort of very preterm infants who were assisted in two Italian NICUs.
METHODS
Preterm infants with gestational age between 23 and 29 weeks were stratified into subgroups of infants who developed ROP and those who did not; their clinical characteristics were compared with univariate and multivariable logistic regression analyses.
RESULTS
We studied a total of 178 infants of whom 67 (38%) developed ROP (stage 1: n = 12; stage 2: n = 41; stage 3: n = 14). Regression analysis demonstrated that maternal milk (OR 0.979, 95% Cl 0.961-0.998) decreased the risk of developing ROP, while intraventricular hemorrhage (IVH) (OR 2.055, 95% Cl 1.120-3.772) increased it. Moreover, maternal milk was found to decrease (OR 0.981, 95% Cl 0.964-0.997) the risk of ROP at discharge, while RBC transfusion increased it (OR 1.522, 95% Cl 1.208-1.916).
CONCLUSIONS
In our cohort the occurrence of ROP was similar to that previously reported. Strategies for promoting the use of mother's own milk, preventing IVH, and standardizing the approach to RBC transfusions could contribute to decreasing the risk of ROP in very preterm infants.
目的
有报道称，不同新生儿重症监护病房（NICU）之间早产儿视网膜病变（ROP）及其危险因素存在显著差异。我们的目的是评估在意大利的两个 NICU 中接受治疗的大数量极早产儿 ROP 的发病情况及其危险因素。
方法
将胎龄在 23 至 29 周之间的早产儿分为 ROP 组和非 ROP 组；并通过单变量和多变量逻辑回归分析比较其临床特征。
结果
共研究了 178 例婴儿，其中 67 例（38%）发生了 ROP（1 期：n=12；2 期：n=41；3 期：n=14）。回归分析表明，母亲的乳汁（OR 0.979，95% Cl 0.961-0.998）降低了 ROP 的发病风险，而脑室出血（IVH）（OR 2.055，95% Cl 1.120-3.772）则增加了其发病风险。此外，发现母亲的乳汁降低了 ROP 的出院风险（OR 0.981，95% Cl 0.964-0.997），而红细胞输血增加了其发病风险（OR 1.522，95% Cl 1.208-1.916）。
结论
在我们的队列中，ROP 的发生情况与之前报道的相似。促进使用母亲自身乳汁、预防 IVH 和规范红细胞输血方法的策略可能有助于降低极早产儿 ROP 的发病风险。
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