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泰国一家农村三级医院早产儿视网膜病变的发病率及危险因素

Incidence and Risk Factors for Retinopathy of Prematurity at a Rural Tertiary Hospital in Thailand.

作者信息

Ittarat Mantapond, Chansaengpetch Supakorn, Chansangpetch Sunee

机构信息

Surin Hospital and School of Ophthalmology, Suranaree University of Technology, Surin, Thailand.

Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.

出版信息

J Ophthalmic Vis Res. 2023 Feb 21;18(1):81-87. doi: 10.18502/jovr.v18i1.12728. eCollection 2023 Jan-Mar.

Abstract

PURPOSE

To estimate the incidence and identify the factors affecting retinopathy of prematurity (ROP) in a rural tertiary hospital in Thailand.

METHODS

This retrospective chart review included all infants screened for ROP. The study included all infants with gestational age (GA) 30 weeks or birth weight (BW) 1,500 gr or selected larger infants with an unstable clinical course. Retinal findings were classified according to the revised International Classification of ROP. Data were analyzed using univariate and multivariable logistic regression analyses.

RESULTS

Of the 113 screened infants, the incidences of any ROP and ROP requiring intervention were 17.7% and 8.8%, respectively. In univariate analysis, lower GA, lighter BW, total days of supplemental oxygen, days of continuous positive airway pressure (CPAP), presence of apnea, and intraventricular hemorrhage (IVH) were associated with the development of any ROP. In the stepwise multivariable logistic regression analysis, lighter BW, male gender, and bronchopulmonary dysplasia (BPD) were significant risk factors for the development of any ROP. Lower GA and being either a twin or triplet were significant risk factors for ROP requiring intervention. However, no antenatal condition was identified as a risk factor for ROP.

CONCLUSION

The incidence of ROP in rural tertiary hospitals was relatively high as compared with previously published data from urban tertiary hospitals. Lighter BW, male gender, and BPD were significantly associated with the development of ROP in a local context. Epidemiological studies are necessary to prevent ophthalmic morbidities.

摘要

目的

评估泰国一家农村三级医院早产儿视网膜病变(ROP)的发病率,并确定影响其发生的因素。

方法

这项回顾性病历审查纳入了所有接受ROP筛查的婴儿。该研究包括所有孕周(GA)≤30周或出生体重(BW)≤1500克的婴儿,或部分临床病程不稳定的较大婴儿。视网膜检查结果根据修订后的国际ROP分类进行分类。采用单因素和多因素逻辑回归分析对数据进行分析。

结果

在113名接受筛查的婴儿中,任何类型ROP和需要干预的ROP的发病率分别为17.7%和8.8%。单因素分析显示,较低的GA、较轻的BW、吸氧总天数、持续气道正压通气(CPAP)天数、呼吸暂停的存在以及脑室内出血(IVH)与任何类型ROP的发生相关。在逐步多因素逻辑回归分析中,较轻的BW、男性性别和支气管肺发育不良(BPD)是任何类型ROP发生的显著危险因素。较低的GA以及双胞胎或三胞胎是需要干预的ROP的显著危险因素。然而,未发现任何产前情况是ROP的危险因素。

结论

与先前发表的城市三级医院数据相比,农村三级医院ROP的发病率相对较高。在当地环境中,较轻的BW、男性性别和BPD与ROP的发生显著相关。开展流行病学研究对于预防眼科疾病很有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/346a/10020780/59f0554d6a40/jovr-18-81-g001.jpg

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