Division of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Associate Professor of Pediatrics, Washington University in St Louis, St. Louis, MO, USA.
J Perinatol. 2023 Jun;43(6):694-701. doi: 10.1038/s41372-023-01604-9. Epub 2023 Jan 18.
To identify gestational age (GA) specific risk factors for severe ROP (sROP).
Single-center cohort stratified by GA into <24 weeks, 24-26 weeks and ≥27 weeks.
132/1106 (11.9%) developed sROP. Time to full feeds was the only risk factor [HR 1.003 (1.001-1.006), p = 0.04] for infants<24 weeks GA. For infants 24-26 weeks GA, a higher GA was protective [HR 0.66 (0.51-0.85), p < 0.01], whereas steroids for bronchopulmonary dysplasia (BPD) [HR 2.21 (1.28-3.26), p < 0.01], patent ductus arteriosus (PDA) ligation [HR 1.99 (1.25-3.11), p < 0.01] and use of nitric oxide [HR 1.96 (1.11-3.30), p = 0.01] increased the hazard of sROP. Increasing birthweight was protective [HR 0.70 (0.54-0.89), p < 0.01] in infants ≥27 weeks GA. Cumulative hazard of sROP reached 1.0 by fifteen weeks for <24 weeks GA, 0.4 by twenty weeks for 24-26 weeks GA, and 0.05 by twenty weeks after birth for ≥27 weeks GA.
Risk factors, cumulative hazard, and time to sROP vary by GA.
确定特定胎龄（GA）的严重早产儿视网膜病变（ROP）风险因素。
按 GA 分层的单中心队列研究，分为<24 周、24-26 周和≥27 周。
132/1106（11.9%）发生 sROP。对于<24 周 GA 的婴儿，完全喂养时间是唯一的风险因素[HR 1.003（1.001-1.006），p=0.04]。对于 24-26 周 GA 的婴儿，GA 较高具有保护作用[HR 0.66（0.51-0.85），p<0.01]，而支气管肺发育不良（BPD）的类固醇[HR 2.21（1.28-3.26），p<0.01]、动脉导管未闭（PDA）结扎[HR 1.99（1.25-3.11），p<0.01]和一氧化氮的使用[HR 1.96（1.11-3.30），p=0.01]增加了 sROP 的危险。在≥27 周 GA 的婴儿中，出生体重增加具有保护作用[HR 0.70（0.54-0.89），p<0.01]。<24 周 GA 的婴儿累积 sROP 危险在 15 周时达到 1.0，24-26 周 GA 时在 20 周时达到 0.4，≥27 周 GA 时在出生后 20 周时达到 0.05。
风险因素、累积危险和 sROP 发生时间因 GA 而异。
