Abstract
Abstract: :
Purpose: To evaluate some of the risk factors for retinopathy of prematurity (ROP). Methods: The study included 60 newborn infants divided into 4 groups. The first group included 10 premature infants who did not need oxygen supplementation. The second group included 20 premature infants who needed oxygen supplementation. The third group included 20 full term infants who needed oxygen supplementation. The fourth group was considered the control group and included 10 healthy full term infants who did not need oxygen supplementation. All cases were subjected to full history taking and examination according to NICU protocol. Thirty-one risk factors for ROP were chosen and included neonatal factors, medications used and maternal factors. Full ophthalmologic examination was carried out at 4-6 postnatal week with special stress on fundus examination with scleral indentation. Examination was repeated every 2 weeks until retinal vascularization was complete. In cases with positive ROP examination was done every week. Retinal findings were classified according to the International Classification of Retinopathy of Prematurity. The data were statistically evaluated using the epidemiological program Epi-info vers 6.04. Results: The incidence of ROP was 20% in the first group, 40%in the second group, 10% in the third group and 0% in the control group. Of the positive cases 16.66% were in stage 1 while 83.33% were in stage 2 of the disease. Univariate analysis showed a statistically significant association between ROP and gestational age, sepsis, exchange transfusion, phototherapy and the child of the primipara mother. In stepwise logistic regression analysis only gestational age, exchange transfusion and phototherapy were significantly associated with ROP. There was no statistically significant association between ROP and birth weight, duration of oxygen supplementation in different concentrations, gender, multiple births , Apgar score at 1 and 5 minutes, pneumonia, apnea,asphyxia, respiratory distress syndrome, convulsions, anemia,jaundice, congenital heart disease, repeated blood transfusion, mean number of days on parental nutrition, treatment with antibiotics, barbiturates, xanthines or diuretics,mode of delivery, preeclampsia, mother cardiac disease, premature rupture of membranes, prenatal anoxia and bleeding during the third trimester . Conclusion: The keyword for ROP is prematurity, that is low gestational age. The degree of systemic illness and stability of the nursery course are important predictors for the development of ROP.
Keywords: 572 retinopathy of prematurity • 355 clinical (human) or epidemiologic studies: risk factor assessment • 566 retinal neovascularization