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Dordi Austeng, Karin Källen, Ann Hellström, Peter Jakobsson, Kent Johansson, Kristina Tornqvist, Agneta Wallin, Gerd Holmström; Regional Differences In The Incidence Of Retinopathy Of Prematurity In Extremely Preterm Infants In Sweden. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3136.
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Previously we have studied national mortality and morbidity in a population of extremely preterm infants born before 27 weeks’ gestation in Sweden. In the present study, we wanted to investigate whether the seven Swedish university regions differ regarding incidence and screening routines of retinopathy of prematurity (ROP) in this population.
A prospective population-based study of extremely preterm infants was performed in Sweden during 2004 to 2007. In each of the seven regions, one obstetric, one pediatric and one ophthalmological study coordinator were responsible for the data collection. Screening for ROP was to be performed weekly from the 5th postnatal week, enabling study of the course and severity of ROP. Early Treatment for ROP (ETROP) recommendations for treatment were followed.
506 infants were screened for ROP during the study period. The region with most infants was used as a reference region to which other regions were compared. There were significant differences regarding incidence of ROP among the regions with variations between 54 and 92 %. The observed heterogeneity in incidences remained after adjustment for GA at birth and other previously described risk factors for ROP in this population. Regarding the incidence of ROP stage 3 and frequency of treatment for ROP, there was also significant heterogeneity between the regions after adjustment for GA at birth and BW. Screening routines deviated in one of the regions with a later first eye examination and a longer interval between examinations compared to the other regions.
Although neonatal care is supposed to be uniform in Sweden, this study reveals regional differences regarding incidence and screening routines for ROP. The heterogeneity of ROP incidences may possibly be caused by observer bias and/or differences in regional neonatal care. Further analyses will be performed together with neonatologists in order to investigate the causes of the patterns observed.
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