Dai Yi, Zhu Li, Zhou Yequn, Wu Yanqiu, Chen Dongmei, Wang Ruiquan, Wu Linlin, Guo Shaoqing, Gao Lingling, Xu Ping, Wang Yang, Dong Shanshan, Liu Ning, Wu Yan, Chen Haoming, Sun Yumei, Chen Chao, Zhang Shulian
Children's Hospital of Fudan University, National Children's Medical Centre, Shanghai, China.
Yantai Yuhuangding Hospital, Yantai, China.
Paediatr Perinat Epidemiol. 2022 May;36(3):380-389. doi: 10.1111/ppe.12810. Epub 2021 Sep 1.
Retinopathy of prematurity (ROP) continues to be a major cause of visual impairment and blindness in premature infants and children.
To investigate the incidence of severe ROP receiving treatment in extremely preterm (EP) infants in China over time. The risk factors for ROP treatment were also assessed.
This was a multicentre retrospective study and a subanalysis of baseline data from the "Outcomes of EP infants in China 2010-2019" study. This study was conducted in 68 tertiary neonatal care centres from 31 provinces of China. Infants with a gestational age of 23 -27 weeks and admitted to a neonatal unit within the first 72 h of life between 2010 and 2019 were enrolled. Incidence of ROP was analysed in infants who survived to 32 weeks postmenstrual age and screened for ROP. Multivariable modified Poisson regression models were used to identify risk factors for ROP treatment.
Among 7295 eligible infants, 4701 (64.5%) survived to 32 weeks postmenstrual age and met ROP screening criteria. Of the 3756 infants who screened and with ROP data, 2320 (61.8%) developed ROP of any stage. The overall incidence of ROP treatment was 12.6%, decreasing from 45.5% at 23 weeks to 8.3% at 27 weeks. During the 10-year period, the incidence of ROP treatment did not change, although the incidence of any ROP increased over time. Independent risk factors associated with ROP treatment included lower gestational age, small for gestational age, multiple birth, severe intraventricular haemorrhage, patent ductus arteriosus and supplemental oxygen duration.
The incidence of EP infants receiving ROP treatment showed no change during this 10-year period in China. Prevention of prematurity and foetal growth restriction, judicious use of oxygen and reducing comorbidities are promising factors that may reduce the incidence of ROP needing treatment in these high-risk infants.
早产儿视网膜病变（ROP）仍然是早产婴儿和儿童视力损害和失明的主要原因。
调查中国极早产儿（EP）中接受治疗的严重ROP的发病率随时间的变化情况。同时评估ROP治疗的危险因素。
这是一项多中心回顾性研究，是对“2010 - 2019年中国EP婴儿结局”研究的基线数据进行的亚分析。该研究在中国31个省份的68家三级新生儿护理中心开展。纳入2010年至2019年期间孕龄为23 - 27周且在出生后72小时内入住新生儿病房的婴儿。对存活至孕龄32周并接受ROP筛查的婴儿的ROP发病率进行分析。采用多变量修正泊松回归模型确定ROP治疗的危险因素。
在7295名符合条件的婴儿中，4701名（64.5%）存活至孕龄32周并符合ROP筛查标准。在3756名接受筛查并拥有ROP数据的婴儿中，2320名（61.8%）出现了任何阶段的ROP。ROP治疗的总体发病率为12.6%，从23周时的45.5%降至27周时的8.3%。在这10年期间，尽管任何ROP的发病率随时间增加，但ROP治疗的发病率没有变化。与ROP治疗相关的独立危险因素包括孕龄较低、小于胎龄儿、多胎妊娠、重度脑室内出血、动脉导管未闭和吸氧持续时间。
在中国，这10年期间接受ROP治疗的EP婴儿的发病率没有变化。预防早产和胎儿生长受限、合理使用氧气以及减少合并症是有望降低这些高危婴儿中需要治疗的ROP发病率的因素。
