Abstract
Purpose :
In Switzerland, the incidence of retinopathy of prematurity (ROP) stages 1 to 5 and of ROP requiring treatment is very low with 9.3 % and 1.2%, respectively. An increase in ROP treatment at our institution was observed after mid-2015. Our aim was to analyze possible reasons associated to this change to inform further management.
Methods :
Retrospective analysis of all preterm infants born 7/2013 to 6/2017 with a gestational age (GA) < 29 completed weeks admitted to the local neonatal intensive care unit during the first 28 days of life. Data collection was based on the definition used for the Swiss Neonatal Network and consisted of 29 variables. Primary outcome was ROP treatment and secondary outcome was severest ROP stage (ROPmax). The remaining 27 variables were explanatory. Statistical analysis was performed using generalized additive models (GAM) in R.
Results :
Significant predictors for ROPmax were GA, days of mechanical ventilation, and multiple births. A composite of severe comorbidities had no significant effect on ROPmax>0. Applying the GAM, GA was identified as the only significant risk factor for ROPmax (p-value < 0.01). This is in accordance with the decreased probability of death over time for infants born with a GA < 29 weeks during the study period.
Conclusions :
Improved care and increased survival rate of extremely preterm infants resulted in an increased risk for ROP at our institution. Despite the increase, the incidence is still very low compared to other countries. No other additive factors were identified.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.