Download fulltext
HTML
1.
Daneshtalab A, Shadravan M, Mobasherzadeh Mahani A, Dehghani A, Sharifzadeh Kermani M. Risk Factors for Retinopathy of Prematurity in Preterm Infants in Kerman, Iran. JOVR [Internet]. 2024Mar.10 [cited 2024Apr.27];19(1):51–57. Available from: https://knepublishing.com/index.php/JOVR/article/view/15437
https://doi.org/10.18502/jovr.v19i1.15437
statistics
- 182 Abstract Views
- 126 PDF Views
- 0 HTML Views
authors
-
Arash Daneshtalab
Arash Daneshtalab
Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
-
Mahla Shadravan
Mahla Shadravan
Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
-
Amirreza Mobasherzadeh Mahani
Amirreza Mobasherzadeh Mahani
Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
-
Azam Dehghani
Azam Dehghani
Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
-
Mahdi Sharifzadeh Kermani
Mahdi Sharifzadeh Kermani
Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
Published Date
- Mar 10, 2024
Risk Factors for Retinopathy of Prematurity in Preterm Infants in Kerman, Iran
Abstract
Purpose: Retinopathy of prematurity (ROP) is the main cause of blindness in premature infants. Despite developments in neonatal care and management guidelines, ROP is becoming increasingly prevalent worldwide. Hence, the identification of risk factors for ROP is critical to diminish the burden of the disease.
Methods: This cross-sectional study included all infants with gestational age ≤ 36 weeks referred to the ophthalmology clinic at Shafa hospital, Kerman, Iran from 2014 to 2015. Ophthalmologic examinations were performed followed by demographic and ophthalmic data collection and analysis.
Results: A total of 579 preterm neonates were screened including 325 boys and 254 girls. The incidence of ROP was 17.96%. Mean birth weight (BW) and gestational age (GA) were 1668.0 grams and 31.2 weeks, respectively. The results indicated that BW, GA, duration of hospitalization and oxygen therapy were significantly related to the development of ROP, however, after multivariate logistic regression analysis, only BW and duration of hospitalization remained significant. There were no significant associations between gender, type of delivery, or assisted reproductive technologies, and ROP (P = 0.461, 0.461, and 0.826, respectively).
Conclusion: BW and duration of hospitalization were significant risk factors for ROP in the current study. BW was also strongly associated with the need for therapy.
Keywords:
Preterm Infant, Retinopathy of Prematurity, Risk Factors
References
1. Blencowe H, Moxon S, Gilbert C. Update on blindness due to retinopathy of prematurity globally and in India. Indian Pediatr 2016;53:S89–S92.
2. Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res 2013;74:35–49.
3. Quinn GE. Retinopathy of prematurity blindness worldwide: Phenotypes in the third epidemic. Eye Brain 2016;8:31.
4. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371:75–84.
5. Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. Global report on preterm birth and stillbirth (1 of 7): Definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth 2010;10:1–22.
6. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet 2013;382:1445–1457.
7. Heidary G, Vanderveen D, Smith LE, editors. Retinopathy of prematurity: Current concepts in molecular pathogenesis. Semin Ophthalmol 2009;24:77–81.
8. Hartnett ME, Penn JS. Mechanisms and management of retinopathy of prematurity. N Engl J Med 2012;367:2515–2526.
9. Smith LE. Through the eyes of a child: Understanding retinopathy through ROP the Friedenwald lecture. Invest Ophthalmol Vis Sci 2008;49:5177–5182.
10. Akçakaya AA, Yaylali SA, Erbil HH, Sadigov F, Aybar A, Aydin N, et al. Screening for retinopathy of prematurity in a tertiary hospital in Istanbul: Incidence and risk factors. J Pediatr Ophthalmol Strabismus 2012;49:21–25.
11. Cunningham S, Mclntosh N, Fleck B, Elton R. Transcutaneous oxygen levels in retinopathy of prematurity. Lancet 1995;346:1464–1465.
12. Alajbegovic-Halimic J, Zvizdic D, Alimanovic-Halilovic E, Dodik I, Duvnjak S. Risk factors for retinopathy of prematurity in premature born children. Med Arch 2015;69:409.
13. Alizadeh Y, Zarkesh M, Moghadam RS, Esfandiarpour B, Behboudi H, Karambin M-M, et al. Incidence and risk factors for retinopathy of prematurity in North of Iran. J Ophthalmic Vis Res 2015;10:424.
14. Allegaert K, Casteels I, Cossey V, Devlieger H. Retinopathy of prematurity: Any difference in risk factors between a high and low-risk population? Eur J Ophthalmol 2003;13:784–788.
15. Mansouri M, Kadivar M, Karkhaneh R, Riazi Esfahani M, Nili Ahmadabadi M, Faghihi H, et al. Prevalence and risk factors of retinopathy of prematurity in very low birth weight or low gestational age infants. Bina J Ophthalmol 2007;12:428–434.
16. Lee J, Dammann O, editors. Perinatal infection, inflammation, and retinopathy of prematurity. Semin Fetal Neonatal Med 2012;17:26–29.
17. Chen ML, Allred EN, Hecht JL, Onderdonk A, VanderVeen D, Wallace DK, et al. Placenta microbiology and histology and the risk for severe retinopathy of prematurity. Invest Ophthalmol Vis Sci 2011;52:7052–7058.
18. Saito Y, Omoto T, Cho Y, Hatsukawa Y, Fujimura M, Takeuchi T. The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefes Arch Clin Exp Ophthalmol 1993;231:151–156.
19. York JR, Landers S, Kirby RS, Arbogast PG, Penn JS. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatol 2004;24:82– 87.
20. Di Fiore JM, Bloom JN, Orge F, Schutt A, Schluchter M, Cheruvu VK, et al. A higher incidence of intermittent hypoxemic episodes is associated with severe retinopathy of prematurity. J Pediatr 2010;157:69–73.
21. Bowe T, Nyamai L, Ademola-Popoola D, Amphornphruet A, Anzures R, Cernichiaro-Espinosa LA, et al. The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela. Digit J Ophthalmol 2019;25:49–58.
22. Fang JL, Sorita A, Carey WA, Colby CE, Murad MH, Alahdab F. Interventions to prevent retinopathy of prematurity: A meta-analysis. Pediatrics 2016;137:e20153387.
23. Petriçli İS, Kara C, Işık DU, Demirel N, Baş AY. Effect of birth weight on retinopathy of prematurity in discordant twin pairs. Indian J Ophthalmol 2019;67:806–810.
24. Bennett A, Wilson DM, Liu F, Nagashima R, Rosenfeld RG, Hintz RL. Levels of insulin-like growth factors I and II in human cord blood. J Clin Endocrinol Metab 1983;57:609– 612.
25. Giudice LC, de Zegher F, Gargosky SE, Dsupin BA, de las Fuentes L, Crystal RA, et al. Insulin-like growth factors and their binding proteins in the term and preterm human fetus and neonate with normal and extremes of intrauterine growth. J Clin Endocrinol Metab 1995;80:1548–1555.
26. Löfqvist C, Hansen-Pupp I, Andersson E, et al. Validation of a new retinopathy of prematurity screening method monitoring longitudinal postnatal weight and insulin-like growth factor I. Arch Ophthalmol 2009;127:622–627.
27. Saeidi R, Taraghi BJIJoNI. Incidence of retinopathy of prematurity (ROP) in low birth weight newborns. 2017;8:102–106.
28. Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: A review of risk factors and their clinical significance. Surv Ophthalmol 2018;63:618– 637.
29. Özkan H, Cetinkaya M, Koksal N, Özmen A, Yıldız M. Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity. J Perinat Med 2011;39:523–527.
30. Wu W-C, Ong FS-C, Kuo JZ-C, Lai C-C, Wang N-C, Chen K-J, et al. Retinopathy of prematurity and maternal age. Retina 2010;30:327–331.
31. Zhu T, Zhang L, Zhao F, Qu Y, Mu DJPO. Association of maternal hypertensive disorders with retinopathy of prematurity: A systematic review and meta-analysis. PLoS One 2017;12:e0175374.
32. Tolsma KW, Allred EN, Chen ML, Duker J, Leviton A, Dammann O. Neonatal bacteremia and retinopathy of prematurity: the ELGAN study. Arch Ophthalmol 2011;129:1555–1563.
33. Darlow BA, Hutchinson JL, Henderson-Smart DJ, Donoghue DA, Simpson JM, Evans NJJP. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics 2005;115:990–996.
34. Wikstrand MH, Hård AL, Niklasson A, Smith L, Löfqvist C, Hellström A. Maternal and neonatal factors associated with poor early weight gain and later retinopathy of prematurity. Acta Paediatr 2011;100:1528–1533.
35. Manzoni P, Farina D, Maestri A, Giovannozzi C, Leonessa M, Arisio R, et al. Mode of delivery and threshold retinopathy of prematurity in pre-term ELBW neonates. Acta Paediatr 2007;96:221–226.
36. Trifonova K, Slaveykov K, Mumdzhiev H, Dzhelebov D. Artificial reproductive technology–A risk factor for retinopathy of prematurity. Open Access Maced J Med Sci 2018;6:2245.
37. Chan RVP, Yonekawa Y, Morrison MA, Sun G, Wong RK, Perlman JM, et al. Association between assisted reproductive technology and advanced retinopathy of prematurity. Clin Ophthalmol 2010;4:1385–1390.
38. Barker L, Bunce C, Husain S, Adams GGW. Is artificial reproductive technology a risk factor for retinopathy of prematurity independent of the generation of multiple births? Eur J Ophthalmol 2017;27:174–178.
2. Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res 2013;74:35–49.
3. Quinn GE. Retinopathy of prematurity blindness worldwide: Phenotypes in the third epidemic. Eye Brain 2016;8:31.
4. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371:75–84.
5. Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. Global report on preterm birth and stillbirth (1 of 7): Definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth 2010;10:1–22.
6. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet 2013;382:1445–1457.
7. Heidary G, Vanderveen D, Smith LE, editors. Retinopathy of prematurity: Current concepts in molecular pathogenesis. Semin Ophthalmol 2009;24:77–81.
8. Hartnett ME, Penn JS. Mechanisms and management of retinopathy of prematurity. N Engl J Med 2012;367:2515–2526.
9. Smith LE. Through the eyes of a child: Understanding retinopathy through ROP the Friedenwald lecture. Invest Ophthalmol Vis Sci 2008;49:5177–5182.
10. Akçakaya AA, Yaylali SA, Erbil HH, Sadigov F, Aybar A, Aydin N, et al. Screening for retinopathy of prematurity in a tertiary hospital in Istanbul: Incidence and risk factors. J Pediatr Ophthalmol Strabismus 2012;49:21–25.
11. Cunningham S, Mclntosh N, Fleck B, Elton R. Transcutaneous oxygen levels in retinopathy of prematurity. Lancet 1995;346:1464–1465.
12. Alajbegovic-Halimic J, Zvizdic D, Alimanovic-Halilovic E, Dodik I, Duvnjak S. Risk factors for retinopathy of prematurity in premature born children. Med Arch 2015;69:409.
13. Alizadeh Y, Zarkesh M, Moghadam RS, Esfandiarpour B, Behboudi H, Karambin M-M, et al. Incidence and risk factors for retinopathy of prematurity in North of Iran. J Ophthalmic Vis Res 2015;10:424.
14. Allegaert K, Casteels I, Cossey V, Devlieger H. Retinopathy of prematurity: Any difference in risk factors between a high and low-risk population? Eur J Ophthalmol 2003;13:784–788.
15. Mansouri M, Kadivar M, Karkhaneh R, Riazi Esfahani M, Nili Ahmadabadi M, Faghihi H, et al. Prevalence and risk factors of retinopathy of prematurity in very low birth weight or low gestational age infants. Bina J Ophthalmol 2007;12:428–434.
16. Lee J, Dammann O, editors. Perinatal infection, inflammation, and retinopathy of prematurity. Semin Fetal Neonatal Med 2012;17:26–29.
17. Chen ML, Allred EN, Hecht JL, Onderdonk A, VanderVeen D, Wallace DK, et al. Placenta microbiology and histology and the risk for severe retinopathy of prematurity. Invest Ophthalmol Vis Sci 2011;52:7052–7058.
18. Saito Y, Omoto T, Cho Y, Hatsukawa Y, Fujimura M, Takeuchi T. The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefes Arch Clin Exp Ophthalmol 1993;231:151–156.
19. York JR, Landers S, Kirby RS, Arbogast PG, Penn JS. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatol 2004;24:82– 87.
20. Di Fiore JM, Bloom JN, Orge F, Schutt A, Schluchter M, Cheruvu VK, et al. A higher incidence of intermittent hypoxemic episodes is associated with severe retinopathy of prematurity. J Pediatr 2010;157:69–73.
21. Bowe T, Nyamai L, Ademola-Popoola D, Amphornphruet A, Anzures R, Cernichiaro-Espinosa LA, et al. The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela. Digit J Ophthalmol 2019;25:49–58.
22. Fang JL, Sorita A, Carey WA, Colby CE, Murad MH, Alahdab F. Interventions to prevent retinopathy of prematurity: A meta-analysis. Pediatrics 2016;137:e20153387.
23. Petriçli İS, Kara C, Işık DU, Demirel N, Baş AY. Effect of birth weight on retinopathy of prematurity in discordant twin pairs. Indian J Ophthalmol 2019;67:806–810.
24. Bennett A, Wilson DM, Liu F, Nagashima R, Rosenfeld RG, Hintz RL. Levels of insulin-like growth factors I and II in human cord blood. J Clin Endocrinol Metab 1983;57:609– 612.
25. Giudice LC, de Zegher F, Gargosky SE, Dsupin BA, de las Fuentes L, Crystal RA, et al. Insulin-like growth factors and their binding proteins in the term and preterm human fetus and neonate with normal and extremes of intrauterine growth. J Clin Endocrinol Metab 1995;80:1548–1555.
26. Löfqvist C, Hansen-Pupp I, Andersson E, et al. Validation of a new retinopathy of prematurity screening method monitoring longitudinal postnatal weight and insulin-like growth factor I. Arch Ophthalmol 2009;127:622–627.
27. Saeidi R, Taraghi BJIJoNI. Incidence of retinopathy of prematurity (ROP) in low birth weight newborns. 2017;8:102–106.
28. Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: A review of risk factors and their clinical significance. Surv Ophthalmol 2018;63:618– 637.
29. Özkan H, Cetinkaya M, Koksal N, Özmen A, Yıldız M. Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity. J Perinat Med 2011;39:523–527.
30. Wu W-C, Ong FS-C, Kuo JZ-C, Lai C-C, Wang N-C, Chen K-J, et al. Retinopathy of prematurity and maternal age. Retina 2010;30:327–331.
31. Zhu T, Zhang L, Zhao F, Qu Y, Mu DJPO. Association of maternal hypertensive disorders with retinopathy of prematurity: A systematic review and meta-analysis. PLoS One 2017;12:e0175374.
32. Tolsma KW, Allred EN, Chen ML, Duker J, Leviton A, Dammann O. Neonatal bacteremia and retinopathy of prematurity: the ELGAN study. Arch Ophthalmol 2011;129:1555–1563.
33. Darlow BA, Hutchinson JL, Henderson-Smart DJ, Donoghue DA, Simpson JM, Evans NJJP. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics 2005;115:990–996.
34. Wikstrand MH, Hård AL, Niklasson A, Smith L, Löfqvist C, Hellström A. Maternal and neonatal factors associated with poor early weight gain and later retinopathy of prematurity. Acta Paediatr 2011;100:1528–1533.
35. Manzoni P, Farina D, Maestri A, Giovannozzi C, Leonessa M, Arisio R, et al. Mode of delivery and threshold retinopathy of prematurity in pre-term ELBW neonates. Acta Paediatr 2007;96:221–226.
36. Trifonova K, Slaveykov K, Mumdzhiev H, Dzhelebov D. Artificial reproductive technology–A risk factor for retinopathy of prematurity. Open Access Maced J Med Sci 2018;6:2245.
37. Chan RVP, Yonekawa Y, Morrison MA, Sun G, Wong RK, Perlman JM, et al. Association between assisted reproductive technology and advanced retinopathy of prematurity. Clin Ophthalmol 2010;4:1385–1390.
38. Barker L, Bunce C, Husain S, Adams GGW. Is artificial reproductive technology a risk factor for retinopathy of prematurity independent of the generation of multiple births? Eur J Ophthalmol 2017;27:174–178.