A study of risk factors affecting outcome of retinopathy of prematurity: a cross-sectional study at tertiary care centre
DOI:
https://doi.org/10.18203/2349-3291.ijcp20250409Keywords:
Neonatal care, Premature infants, Prevention strategies, Retinopathy of prematurity, Risk factorsAbstract
Background: Retinopathy of prematurity (ROP) remains a significant cause of preventable blindness in premature infants. This study aimed to analyze various risk factors affecting ROP outcomes in a tertiary care setting.
Methods: A cross-sectional study was conducted at the Neonatal Care Unit of Guru Gobindsingh Government Hospital and Shri M.P. Shah Government Medical College, Jamnagar, over 10 months, enrolling 180 newborns with ROP. Risk factors were analyzed using descriptive statistics and Chi-square tests, with p<0.05 considered statistically significant.
Results: The study identified several risk factors significantly associated with progression to severe ROP requiring intervention: early gestational age, lower birth weight, neonatal sepsis, respiratory distress syndrome, oxygen requirement >7 days, and blood transfusion. Among these, neonatal sepsis, respiratory distress, and prolonged oxygen requirement were identified as preventable factors. Conversely, antenatal steroid administration, exclusive breastfeeding, and surfactant use were associated with decreased ROP severity.
Conclusions: While factors like sepsis, prolonged oxygen requirement, low birth weight, respiratory distress syndrome, and blood transfusions were associated with more severe ROP stages, protective factors included exclusive breastfeeding, antenatal steroids, and surfactant use. This understanding can help develop targeted preventive strategies and improve outcomes in premature infants at risk for ROP.
Metrics
References
Terry TL. Extreme Prematurity and Fibroblastic Overgrowth of Persistent Vascular Sheath Behind Each Crystalline Lens∗: I. Preliminary Report. Am J Ophthalmol. 2018;192:xxviii. DOI: https://doi.org/10.1016/j.ajo.2018.05.024
Hellström A, Smith L, Dammann O. Retinopathy of prematurity. The Lancet. 2013;382(9902):1445-57. DOI: https://doi.org/10.1016/S0140-6736(13)60178-6
Blencowe H, Lawn J, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74(S1):35-49. DOI: https://doi.org/10.1038/pr.2013.205
Kim S, Port A, Swan R, Campbell J, Chan R, Chiang M. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018;63(5):618-37. DOI: https://doi.org/10.1016/j.survophthal.2018.04.002
Mintz-Hittner H, Kennedy K, Chuang A. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Medi. 2011;364(7):603-15. DOI: https://doi.org/10.1056/NEJMoa1007374
Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatr. 2018;142(6):e20183061. DOI: https://doi.org/10.1542/peds.2018-3061
Wang X, Tang K, Chen L, Cheng S, Xu H. Association between sepsis and retinopathy of prematurity: a systematic review and meta-analysis. BMJ Open. 2019;9(5):e025440. DOI: https://doi.org/10.1136/bmjopen-2018-025440
Dammann O, Rivera J, Chemtob S. The prenatal phase of retinopathy of prematurity. Acta Paediatrica. 2021;110(9):2521-8. DOI: https://doi.org/10.1111/apa.15945
Freitas A, Mörschbächer R, Thorell M, Rhoden E. Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study. Int J Reti Vitreous. 2018;4(1). DOI: https://doi.org/10.1186/s40942-018-0125-z
Fernández J, E F, Campos‐Martínez A, Ruiz-López A, García-Serrano J. Blood products transfusion and retinopathy of prematurity: a cohort study. Acta Ophthalmolog. 2022;101(3). DOI: https://doi.org/10.1111/aos.15269
Glaser K, Härtel C, Dammann O, Herting E, Andres O, Speer C, et al. Erythrocyte transfusions are associated with retinopathy of prematurity in extremely low gestational age newborns. Acta Paediatr. 2023;112(12):2507-15. DOI: https://doi.org/10.1111/apa.16965
Hengartner T, Adams M, Pfister R, Snyers D, McDougall J, Held-Egli K, et al. Associations between red blood cell and platelet transfusions and retinopathy of prematurity. Neonatol. 2020;117(5):562-8. DOI: https://doi.org/10.1159/000512020
Chawla S, Wyckoff M, Rysavy M, Patel R, Chowdhury D, Natarajan G, et al. Association of antenatal steroid exposure at 21 to 22 weeks of gestation with neonatal survival and survival without morbidities. JAMA Network Open. 2022;5(9):e2233331.
Travers CP, Clark RH, Spitzer AR, Das A, Garite TJ, Carlo WA. Exposure to any antenatal corticosteroids and outcomes in preterm infants by gestational age: prospective cohort study. Bmj. 2017;356. DOI: https://doi.org/10.1136/bmj.j1039
Tsai A, Acaba-Berrocal L, Sobhy M, Cole E, Ostmo S, Jonas K, et al. Current management of retinopathy of prematurity. Current Treatment Options in Pediatrics. 2022;8(3):246-61. DOI: https://doi.org/10.1007/s40746-022-00249-8
Ryu J. New aspects on the treatment of retinopathy of prematurity: currently available therapies and emerging novel therapeutics. Int J Mole Sci. 2022;23(15):8529. DOI: https://doi.org/10.3390/ijms23158529