Risk Factors for Retinopathy of Prematurity in Premature Born Children

Abstract

Introduction:Retinopathy of Prematurity (ROP) represent disease of the eye in premature born children which affects immature blood vessels of the retina during their development. The emergence of retinopathy of prematurity depends on the interaction of multiple factors, such as: gestational age, low birth weight, hypoxia, duration of oxygen supplementation, respiratory distress syndrome, twin pregnancy, anemia, blood transfusions, sepsis, intraventricular hemorrhage, hypotension, hypothermia, etc. If remain unrecognized and untreated it can cause severe visual impairment and blindness in children, but can also be prevented with timely screening.Goals:To establish the number of patients with development of retinopathy of prematurity active forms in the observed time period and examine which risk factors have most significant impact on its origin.Material and methods:In a clinical, retrospective study we observed a total of 80 premature born children in the period from January to May 2015 with regard to listed risk factors identified for eye examination.Results:From a total of 80 premature newborns sample included 48.8% male and 51.2% female children. The active form of ROP developed in 6.2% of cases, while in 93.8% of cases there was a spontaneous resolution. Patients who developed active form of ROP have significantly younger gestational age (26.4±1.5 weeks) and lower birth weight (874±181 grams), lower Apgar score in the first and fifth minute and were longer on oxygen therapy (20±3.4 days).Conclusion:Of the potential risk factors that could affect the development of ROP active form following factors have a statistically significant influence: early gestational age, low birth weight, lower Apgar score and prolonged oxygen therapy (p <0.05).

Low Apgar scores at both one and five minutes are associated with long‐term neurological morbidity

“…Similar associations have been described with central auditory impairment and poor cochlear function . A decreased Apgar score is a risk factor for visual impairment, including retinopathy of prematurity in preterm children and optic nerve hypoplasia . In the present study, a low five‐minute Apgar score was independently associated with sensorineural defects.…”

Low APGAR Score as a Risk Factor for Retinopathy of Prematurity

“…The association of ROP was more strongly seen with APGAR at 1 minute (r 2 =0.81) than APGAR at 5 minutes (r 2 =0.61). Similar to ours Alajbejovic J. et al (8) in their study found out that low APGAR at 1 minute (3.20±1.30) and 5 minutes (5.20±1.09) were significantly associated (p=0.002; p=0.001 respectively) with occurrence of ROP. Also, study conducted by Chirico G et al (9) the association of ROP was significantly associated with low APGAR score at 1 minute and 5 minutes (p<0.001; p<0.0001 respectively).…”

Retinopathy of prematurity risk factors: Does human milk prevent retinopathy of prematurity?

“…The results of many studies involving aforementioned risk factors were similar to this study and excluding the oxygen supplement policy the only other risk factors determined in this study which can be modified is human breast milk. [1][2][3][4][5][6][7][13][14][15][16][17][18] The effect of human breast milk on ROP development is a controversial issue in the literature. [19][20][21][22][23][24][25] As far as we know, studies about the pathophysiological relationship between ROP and human breast milk are limited.…”

“…The results are similar to other developing countries. 2,5,6,16,17 Although approved guidelines for the diagnosis and treatment of ROP were used in our study, these guidelines did not include babies born at the 33rd-34th gestational weeks who needed laser treatment in our study. The National Neonatology and Ophthalmology Clinics of our country released a guideline for ROP screening and treatment in 2016.…”

“…Frequent blood transfusions, severe infections, intracranial hemorrhages, bronchopulmonary diseases and artificial ventilation are the other well-known important risk factors. [1][2][3][4][5][6][7][13][14][15][16][17][18] These risk factors are closely related with the natural course of the disease. For example; immaturity of bone marrow, lymphoid tissue and liver is responsible from infections, hemorrhages and increased need of blood transfusion.. Immature bronchopulmonary tissue causes the prolonged need of artificial ventilation.…”