Risk factors for the development and progression of retinopathy of prematurity in preterm infants in Indonesia

Siswanto, Johanes Edy; Ronoatmodjo, Sudarto; Adisasmita, Asri C.; Soemantri, Augustinus; Sitorus, Rita S; Sauer, Pieter

doi:10.3233/npm-190233

Cited by 8 publications

(12 citation statements)

References 20 publications

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“…Necrotizing enterocolitis did not represent a significant risk factor for the onset of retinopathy, although several studies consider it as a risk factor for ROP. 28 , 29 …”

Section: Discussionmentioning

confidence: 99%

“…Necrotizing enterocolitis did not represent a significant risk factor for the onset of retinopathy, although several studies consider it as a risk factor for ROP. 28,29 Finally, in multivariate analysis, gestational age (<32 weeks), weight (<1500 g), sepsis, vaginal delivery and hyaline membrane disease are presented as significant predictors of retinopathy in preterm infants (Table 4). Other studies also show that gestational age, low birth weight and hyaline membrane disease are predictors of retinopathy of prematurity.…”

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confidence: 99%

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Incidence and Risk Factors Associated with Retinopathy of Prematurity in Peru

Carranza-Mendizabal¹,

Diaz-Manrique²,

Mamani

et al. 2021

OPTH

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The purpose of this research is to determine retinopathy of prematurity (ROP) prevalence and possible risk factors associated with ROP development in newborns admitted to a neonatal unit of a Peruvian National Reference Hospital. Patients and Methods: This retrospective study included 216 preterm infants. The data were collected between January 2016 and December 2018. All infants were examined according to Peruvian guidelines for screening and treatment of ROP. The association of clinical risk factors and the development of ROP was analyzed and predictive factors were determined. Results:The study subjects were 216 preterm infants of which 72 had some stage of ROP (32 stage 1; 23 stage 2 and 17 stage 3) and 144 preterm infants without ROP. The incidence of ROP in preterm infants less than 32 weeks was 60.9%, while for those weighing less than 1500 g it was 71.6%. The factors associated with ROP were gestational age below 32 weeks, birth weight below 1500 grams, neonatal sepsis, oxygen therapy, mechanical ventilation, hyaline membrane disease, bronchopulmonary dysplasia, persistence of ductus arteriosus and intraventricular hemorrhage. Exclusive breastfeeding was found to play a protective role against ROP. Binary logistic regression analysis found that only gestational age below 32 weeks (OR, 2.637; 95% CI, 1.04-6.69), weight below 1500 grams (OR, 4.377; 95% CI, 1.75-10.92), neonatal sepsis (OR, 6.517; 95% CI, 2.81-15.14), vaginal delivery (OR, 3.748; 95% CI: 1.54-9.14), and the presence of hyaline membrane disease (OR, 3.58; 95% CI,) are predictors of ROP. Conclusion:The incidence of ROP among very low birth weight infants was 71.6%. Infants with weight below 1500 grams, neonatal sepsis, presence of hyaline membrane disease whose mother had vaginal delivery are at risk for the development of ROP. Thus, preventing premature births and encouraging exclusive breastfeeding are two main ways to prevent ROP.

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“…Necrotizing enterocolitis did not represent a significant risk factor for the onset of retinopathy, although several studies consider it as a risk factor for ROP. 28 , 29 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Incidence and Risk Factors Associated with Retinopathy of Prematurity in Peru

Carranza-Mendizabal¹,

Diaz-Manrique²,

Mamani

et al. 2021

OPTH

View full text Add to dashboard Cite

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“…Many studies showed that blood transfusions increase the risk of ROP 44‐46 . A study in Indonesia showed that the risk was also increased when an exchange transfusion was done 47 . The increased risk might be due to either the administration of adult hemoglobin or the iron overload resulting from the transfusions.…”

Section: Other Factors Increasing the Risk To Develop Ropmentioning

confidence: 99%

“…[44][45][46] A study in Indonesia showed that the risk was also increased when an exchange transfusion was done. 47…”

Section: Introductionmentioning

confidence: 99%

How to prevent ROP in preterm infants in Indonesia?

Siswanto

Dijk

Bos

et al. 2021

Health Science Reports

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Background and Aims Retinopathy of prematurity (ROP) is a severe disease in preterm infants. It is seen more frequently in Low‐Middle Income Countries (LMIC) like Indonesia compared to High‐Income Countries (HIC). Risk factors for ROP development are ‐extreme‐ preterm birth, use of oxygen, neonatal infections, respiratory problems, inadequate nutrition, and blood and exchange transfusions. In this paper, we give an overview of steps that can be taken in LMIC to prevent ROP and provide guidelines for screening and treating ROP. Methods Based on the literature search and data obtained by us in Indonesia's studies, we propose guidelines for the prevention, screening, and treatment of ROP in preterm infants in LMIC. Results Prevention of ROP starts before birth with preventing preterm labor, transferring a mother who might deliver <32 weeks to a perinatal center and giving corticosteroids to mothers that might deliver <34 weeks. Newborn resuscitation must be done using room air or, in the case of very preterm infants (<29‐32 weeks) by using 30% oxygen. Respiratory problems must be prevented by starting continuous positive airway pressure (CPAP) in all preterm infants <32 weeks and in case of respiratory problems in more mature infants. If needed, the surfactant should be given in a minimally invasive manner, as ROP's lower incidence was found using this technique. The use of oxygen must be strictly regulated with a saturation monitor of 91‐95%. Infections must be prevented as much as possible. Both oral and parenteral nutrition should be started in all preterm infants on day one of life with preferably mothers' milk. Blood transfusions can be prevented by reducing the amount of blood needed for laboratory analysis. Discussion Preterm babies should be born in facilities able to care for them optimally. The use of oxygen must be strictly regulated. ROP screening is mandatory in infants born <34 weeks, and infants who received supplemental oxygen for a prolonged period. In case of progression of ROP, immediate mandatory treatment is required. Conclusion Concerted action is needed to reduce the incidence of ROP in LMIC. "STOP ‐ R1O2P3" is an acronym that can help implement standard practices in all neonatal intensive care units in LMIC to prevent development and progression.

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“…[44][45][46] A study in Indonesia showed that the risk was also increased when an exchange transfusion was done. [47] The increased risk might be due to either the administration of adult hemoglobin or the iron overload resulting from the transusions. Iron overload increases the risks of oxygen radicals.…”

Section: Blood and Exchange Transfusionmentioning

confidence: 99%

Retinopathy of Prematurity: How to prevent retinopathy of prematurity in Indonesia?

Siswanto¹

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Risk factors for the development and progression of retinopathy of prematurity in preterm infants in Indonesia

Cited by 8 publications

References 20 publications

Incidence and Risk Factors Associated with Retinopathy of Prematurity in Peru

Incidence and Risk Factors Associated with Retinopathy of Prematurity in Peru

How to prevent ROP in preterm infants in Indonesia?

Retinopathy of Prematurity: How to prevent retinopathy of prematurity in Indonesia?

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