Incidence, Severity, and Risk Factors of Retinopathy of Prematurity in Central Maharashtra, India
Snehal Thakre, Pradnya Deshmukh, Ganesh Kalyanshetti, Jyotika Mishrikotkar
Abstract
Aim: To study the incidence, severity, and risk factors of retinopathy of prematurity (ROP) in a tertiary healthcare center and to validate the need for screening even neonates with higher birth weight and gestational age for ROP
Materials and Methods: This prospective, observational study was conducted in a level-3 neonatal intensive care unit of a teaching hospital. A total of 119 neonates were screened for ROP, as per the guidelines of the National Neonatology Forum of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP.
Results: The overall incidence of ROP was 27.73% (33/119). The mean birth weight and gestational age of neonates with ROP were 1390 g and 31.1 weeks, respectively. Of the neonates diagnosed with ROP, 42.42% had a gestational age of > 32 weeks and/or a birth weight of > 1500 g. The incidence of type 1 ROP or treatable ROP was 39.39%.
The risk factors associated with ROP on univariate analysis were birth weight, gestational age, postconceptional age, respiratory distress syndrome (RDS), sepsis, blood transfusion, apnea of prematurity, and ventilation. On multivariate analysis, birth weight, ventilation, blood transfusion, RDS, and sepsis were found to be significant predictors of the increased risk of ROP.
Conclusions: ROP is strongly associated with small, immature, and sick neonates. About 40% of the neonates who developed ROP had higher gestational age (> 32 weeks) and birth weight (> 1500 g)—this observation would have been missed if western screening guidelines were used.
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