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Risk factors for retinopathy of prematurity in very low birth-weight infants. 2003

Hui-Ju Lin, and Cheng-Chieh Lin, and Shih-Wei Tsai, and Horg-Chin Lin, and Bai-Horng Su
Department of Ophthalmology, China Medical University, Taichung, Taiwan, ROC. d2396@www.cmch.org.tw

OBJECTIVE To calculate incidence and evaluate the risk factors of the threshold retinopathy of prematurity (ROP) in very low birth-weight (VLBW, birth weight less than 1,251 gram) infants. We also compared the incidence of threshold ROP in Taiwan with those of Caucasians and Negros. Additionally, the post-conception age when threshold ROP happened was considered. METHODS From February 1995 to February 2000, we enrolled 458 VLBW infants at the China Medical College Hospital. Patients with congenital anomalies and those who survived less than 6 months were excluded. The perinatal and neonatal data of enrolled infants were reviewed. Student's t test and chi-square test were used to evaluate the statistical significance of risk factors. We also used logistic regression test and correct classification rate to evaluate different risk factors. RESULTS The incidence of threshold ROP in our study was 6.8%. The gestational age (GA), birth weight (BW), number of days in using ventilator, continuous positive airway pressure (CPAP) and oxygen supplements, the occurrence of broncopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and the length of hospitalization were statistically different between patients groups with and without threshold ROP (p < 0.05). However, small size for gestational age (SGA), sepsis status, intraventricular hemorrhage (IVH) status (Gr.III and Gr.IV) and type of delivery were not significantly different between patients with and without threshold ROP (p > 0.05). Threshold ROP was noted at an average post-conception age of 34.25 weeks. CONCLUSIONS The incidence of threshold ROP (6.8%) in VLBW Taiwan babies is comparable with the incidence of Caucasian patients in Western countries. Risk factors including PVL, NEC, BPD and RDS should be avoided to prevent the occurrence of threshold ROP. Threshold ROP occurred at an average of 34.3 weeks of post-conception age; the premature baby around this age must be checked carefully.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007969 Leukomalacia, Periventricular Degeneration of white matter adjacent to the CEREBRAL VENTRICLES following cerebral hypoxia or BRAIN ISCHEMIA in neonates. The condition primarily affects white matter in the perfusion zone between superficial and deep branches of the MIDDLE CEREBRAL ARTERY. Clinical manifestations include VISION DISORDERS; CEREBRAL PALSY; PARAPLEGIA; SEIZURES; and cognitive disorders. (From Adams et al., Principles of Neurology, 6th ed, p1021; Joynt, Clinical Neurology, 1997, Ch4, pp30-1) Cystic Periventricular Leukomalacia,Encephalomalacia, Periventricular,Neonatal Cerebral Leukomalacia,Periventricular Leukomalacia,Leucomalacia, Periventricular,Cerebral Leukomalacia, Neonatal,Cerebral Leukomalacias, Neonatal,Cystic Periventricular Leukomalacias,Encephalomalacias, Periventricular,Leucomalacias, Periventricular,Leukomalacia, Cystic Periventricular,Leukomalacia, Neonatal Cerebral,Leukomalacias, Cystic Periventricular,Leukomalacias, Neonatal Cerebral,Leukomalacias, Periventricular,Neonatal Cerebral Leukomalacias,Periventricular Encephalomalacia,Periventricular Encephalomalacias,Periventricular Leucomalacia,Periventricular Leucomalacias,Periventricular Leukomalacia, Cystic,Periventricular Leukomalacias,Periventricular Leukomalacias, Cystic
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D012127 Respiratory Distress Syndrome, Newborn A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause. Infantile Respiratory Distress Syndrome,Neonatal Respiratory Distress Syndrome,Respiratory Distress Syndrome, Infant
D001997 Bronchopulmonary Dysplasia A chronic lung disease developed after OXYGEN INHALATION THERAPY or mechanical ventilation (VENTILATION, MECHANICAL) usually occurring in certain premature infants (INFANT, PREMATURE) or newborn infants with respiratory distress syndrome (RESPIRATORY DISTRESS SYNDROME, NEWBORN). Histologically, it is characterized by the unusual abnormalities of the bronchioles, such as METAPLASIA, decrease in alveolar number, and formation of CYSTS. Dysplasia, Bronchopulmonary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012178 Retinopathy of Prematurity A bilateral retinopathy occurring in premature infants treated with excessively high concentrations of oxygen, characterized by vascular dilatation, proliferation, and tortuosity, edema, and retinal detachment, with ultimate conversion of the retina into a fibrous mass that can be seen as a dense retrolental membrane. Usually growth of the eye is arrested and may result in microophthalmia, and blindness may occur. (Dorland, 27th ed) Retrolental Fibroplasia,Fibroplasia, Retrolental,Fibroplasias, Retrolental,Prematurity Retinopathies,Prematurity Retinopathy,Retrolental Fibroplasias
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D019102 Infant, Very Low Birth Weight An infant whose weight at birth is less than 1500 grams (3.3 lbs), regardless of gestational age. Very Low Birth Weight,Very-Low-Birth-Weight Infant,Infant, Very-Low-Birth-Weight,Infants, Very-Low-Birth-Weight,Very Low Birth Weight Infant,Very-Low-Birth-Weight Infants
D020345 Enterocolitis, Necrotizing ENTEROCOLITIS with extensive ulceration (ULCER) and NECROSIS. It is observed primarily in LOW BIRTH WEIGHT INFANT. Necrotizing Enterocolitis

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