The assessment of risk factors for retinopathy of prematurity

Abstract

Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants. Our study was conducted in order to determine which risk factors lead to the development of retinopathy of prematurity. This retrospective study included 108 newborns with birth weight (BW) < 1500 g and gestation age (GA) < 33 weeks, over the period of two years, who were treated at the Clinic of Pediatric, University Hospital, Clinic Centre Banja Luka. In all preterm children, the impact of risk factors conditioned preterm birth (gestational age and birth weight), parameters of general health status (respiratory distress syndrome, apnea, perinatal asphyxia, frequent use of blood derivatives, sepsis, hyperbilirubinemia) and parameters of the treatment with oxygen therapy. Out of 108 infants who fit the screening criteria, ROP was detected in 64 (59.2%) infants, 21(19.4%) of which had severe ROP requiring surgical intervention. Severe ROP was expressed in only 7.8% (5/64) of infants with GA > 30 weeks and in 12.5% (8/64) of infants with BW > 1250 g, compared to 25% (16/64) of infants with GA < 30 weeks and 20.3% (13/64) of infants with BW < 1250 g. The incidence of severe ROP was statistically significantly more frequent with progressively smaller birth weight BW < 1250 g (p <0.01) and the lower GA (gestational age) < 30 weeks (p <0.01). Using multiple logistic regression analysis for ROP, a long-term oxygen therapy (OR,15:54CI, 1.99-120.79) and a long duration of mechanical ventilation (OR,9.97; CI,3.06-32.51), there were obtained factors with a strong connection to the development of severe ROP. The following factors have a slightly lower correlation to the development of severe ROP: birth weight < 1250 g, gestation age < 30 weeks, respiratory distress syndrome, apnea, frequent use of blood derivatives and early sepsis. Prematurity and low birth weight are significant risk factors for the development of ROP. Compromised pulmonary function with long-term oxygen therapy and frequent use of blood derivatives are important factors in the development of severe ROP.