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Yi hsing Chen, Wei-Chi Wu, II; Natural History And Risk Factors Analysis For Retinopathy Of Prematurity In Premature Infants In Taiwan: A Prospective Study At The Post Bevacizumab Era. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6776.
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To study the natural history and the major risk factors of ROP among the infants in Taiwan.
A prospective natural history study of ROP was performed for all premature infants from June 2010 to July 2011 at our children’s hospital. Patients were screened with birth weight (BW) less than 1500 grams or gestational age (GA) less than 32 weeks or selected infants with BW more than 1500 grams or GA more than 32 weeks with an unstable clinical course, including those requiring cardiorespiratory support and who are believed to be high risk by their pediatrician. The incidence of advanced ROP, the need for laser, Bevacizumab, or vitrectomy treatment was documented. The associated risk factors for the development of ROP were recorded.
We enrolled 223 premature infants, and 98 infants (44%) developed ROP. The mean gestational age (GA) was 29.2 ± 3.0 (range 28-36) weeks and the mean BW was 1247.0 ± 441.5 (range 700-2705) grams. The incidence of ROP among BW more and less than 1500 grams was 3 and 60.3%, respectively. The incidence of ROP among GA less than 30 weeks and between 30 to 32 weeks was 8.9 and 15.9% respectively. The average post menstrual age (PMA) for stage 1, 2, 3, 4 and 5 ROP was 33.5 ± 2.5, 33.6 ± 2.0, 34.2 ± 1.9, 43.8 ± 14.5 and 43.7 ± 4.5 respectively. The average PMA of infants having received laser/ Bevacizumab and vitrectomy was 34.5 ± 3.1 and 40.5 ± 4.0 respectively. The younger the PMA at onset of ROP, the more it was significantly related to severity of ROP (P< 0.001). The PMA for stage 3 ROP development was 33 weeks for infants whose BW less than 750 grams and between 750 to 1000 grams, and was 37 weeks for infants whose BW between 1000 to 1500 grams. Among all the risk factors, GA, BW, oxygen support duration, intubation duration, Apar score at 1 and 5 minutes, patent ductus arteriosus, intraventricular hemorrhage, respiratory distress syndrome, necrotizing enterocolitis, bronchopulmonary disease, sepsis, pneumonia, blood transfusion, Surfactant usage, Cesarean section, chorioamnionitis, pregnancy induced hypertension, and preeclampsia were associated with ROP development.
Our natural history study of ROP in Taiwan has shown a decrease in incidence of developing ROP and earlier PMA for the treatment of pre-threshold ROP at the post-bevacizumab era. Major risk factors still account for the development of ROP.
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