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Zarei M, Bazvand F, Ebrahimiadib N, Roohipoor R, Karkhaneh R, Farahani Dastjani A, Imani Fouladi M, Riazi Esfahani M, Khodabande A, Davoudi S, Ghasemi H, S Modjtahedi B. Prevalence and Risk Factors of Retinopathy of Prematurity in Iran. JOVR [Internet]. 2019Jul.18 [cited 2024Apr.26];14(3):291–298. Available from: https://knepublishing.com/index.php/JOVR/article/view/4785
https://doi.org/10.18502/jovr.v14i3.4785
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authors
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Mohammad Zarei
Mohammad Zarei
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Fatemeh Bazvand
Fatemeh Bazvand
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Nazanin Ebrahimiadib
Nazanin Ebrahimiadib
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Ramak Roohipoor
Ramak Roohipoor
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Reza Karkhaneh
Reza Karkhaneh
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Afsar Farahani Dastjani
Afsar Farahani Dastjani
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Marjan Imani Fouladi
Marjan Imani Fouladi
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Mohammad Riazi Esfahani
Mohammad Riazi Esfahani
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, USA
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Alireza Khodabande
Alireza Khodabande
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Samaneh Davoudi
Samaneh Davoudi
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA
-
Hamed Ghasemi
Hamed Ghasemi
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
-
Bobeck S Modjtahedi
Bobeck S Modjtahedi
Eye Monitoring Center, Kaiser Permanente Southern California, CA, USA
Published Date
- Jul 18, 2019
Prevalence and Risk Factors of Retinopathy of Prematurity in Iran
Abstract
Purpose: The present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants.
Methods: A retrospective cohort study was conducted on infants who had undergone screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age ≤ 28 weeks), extremely low-birth-weight (≤ 1000 g), and multiplegestation (MG) infants.
Results: The prevalence of ROP was 27.28% (n = 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion (P < 0.0001, P < 0.0001, and P = 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP (P < 0.0001) were observed in EP and ELBW infants. Birth weight (P = 0.088), history of transfusion (P = 0.066), and intubation (P = 0.053) were not associated with increased risk of ROP in EP infants, while gestational age (P = 0.037) and history of transfusion (P = 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P < 0.001) and birth weight (P = 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis.
Conclusion: ROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines.
Keywords:
Epidemiology; Frequency; Infants; Pediatric; Retinopathy of Prematurity; Risk Factors
References
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2. Domanico R, Davis DK, Coleman F, Davis BO. Documenting the NICU design dilemma: Comparative patient
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4. Good WV, Hardy RJ, Dobson V, Palmer EA, Phelps DL, Quintos M, et al. The incidence and course of retinopathy
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6. Port AD, Paul Chan RV, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity: insights
from outlier infants. Graefes Arch Clin Exp Ophthalmol 2014;252:1669–1677.
7. Palmer EA, Flynn JT, Hardy RJ, Phelps DL, Phillips CL, Schaffer DB, et al. Incidence and early course of
retinopathy of prematurity. The cryotherapy for retinopathy of prematurity cooperative group. Ophthalmology
1991;98:1628–1640.
8. Bossi E, Koerner F, Flury B, Zulauf M. Retinopathy of prematurity: A risk factor analysis with univariate and
multivariate statistics. Helv Paediatr Acta 1984;39:307– 317.
9. Yin H, Li XX, Li HL, Zhang W. Incidence and risk factor analysis of retinopathy of prematurity. Zhonghua Yan Ke
Za Zhi 2005;41:295–299.
10. Chattopadhyay MP, Pradhan A, Singh R, Datta S. Incidence and risk factors for retinopathy of prematurity in neonates. Indian Pediatr 2015;52:157.
11. Chen Y, Xun D, Wang YC, Wang B, Geng SH, Chen H, et al. Incidence and risk factors of retinopathy of prematurity in two neonatal Intensive Care Units in North and South China. Chin Med J 2015;128:914–918.
12. Liu Q, Zin Z, Ke N, Chen L, Chen XK, Fang J, et al. Incidence of retinopathy of prematurity in Southwestern China and analysis of risk factors. Med Sci Monit 2014;20:1442–1451.
13. Seiberth V, Linderkamp O. Risk factors in retinopathy of prematurity: A multivariate statistical analysis. Ophthalmologica 2000;214:131–135.
14. Larsson E, Carle-Petrelius B, Cernerud G, Ots L, Wallin A, Holmstrom G. Incidence of ROP in two consecutive
Swedish population based studies. Br J Ophthalmol 2002;86:1122–1126.
15. Saeidi R, Hashemzadeh A, Ahmadi S, Rahmani S. Prevalence and predisposing factors of retinopathy of prematurity in very low-birth-weight infants discharged from NICU. Iran J Pediatr 2009;19:59–63.
16. Mohamed S, Murray JC, Dagle JM, Colaizy T. Hyperglycemia as a risk factor for the development of retinopathy of prematurity. BMC Pediatr 2013;13:78.
17. Mutlu FM, Altinsoy HI, Mumcuoglu T, Kerimoglu H, Kilic S, Kul M, et al. Screening for retinopathy of prematurity in a tertiary care newborn unit in Turkey: Frequency, outcomes, and risk factor analysis. J Pediatr Ophthalmol Strabismus 2008;45:291–298.
18. Kim J, Jin JY, Kim SS. Postnatal weight gain in the first two weeks as a predicting factor of severe retinopathy of prematurity requiring treatment. Korean J Pediatr 2015;58:52–59.
19. Khalesi N, Shariat M, Fallahi M, Rostamian G. Evaluation of risk factors for retinopathy in preterm infant: A case-control study in a referral hospital in Iran. Minerva Pediatrica 2015;67:231–237.
20. Weintraub Z, Carmi N, Elouti H, Rumelt S. The association between stage 3 or higher retinopathy of prematurity and other disorders of prematurity. Can J Ophthalmol 2011;46:
419.
21. Yau GS, Lee JW, Tam VT, Liu CC, Wong IY. Risk factors for retinopathy of prematurity in extremely preterm Chinese infants. Medicine (Baltimore) 2014;93:e314.
22. Fortes Filho JB, Eckert GU, Procianoy L, Barros CK, Procianoy RS. Incidence and risk factors for retinopathy of
prematurity in very low and in extremely low birth weight infants in a unit-based approach in southern Brazil. Eye 2009;23:25–30.
23. Kumar P, Sankar MJ, Deorari A, Azad R, Chandra P, Agarwal R, et al. Risk factors for severe retinopathy of
prematurity in preterm low birth weight neonates. Indian J Pediatr 2011;78:812–816.
24. Fortes Filho JB, Borges Fortes BG, Tartarella MB, Procianoy RS. Incidence and main risk factors for severe
retinopathy of prematurity in infants weighing less than 1000 grams in Brazil. J Trop Pediatr 2013;59:502–506.
25. Celebi ARC, Petricli IS, Hekimoglu E, Demirel N, Bas AY. The incidence and risk factors of severe retinopathy of
prematurity in extremely low birth weight infants in Turkey. Med Sci Monit 2014;20:1647–1653.
26. Gschlieer A, Stifter E, Neumayer T, Moser E, Papp A, Dorner G, et al. Twin-twin transfusion syndrome as a
possible risk factor for the development of retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol
2015;253:151–156.
27. Yau GS, Lee JW, Tam VT, Yip S, Cheng E, Liu CC, et al. Differences in risk factors for retinopathy of prematurity
development in paired twins: A Chinese population study. Sci World J 2014;2014:212183.
28. Azad R, Chandra P, Patwardhan SD, Gupta A. Profile of asymmetrical retinopathy of prematurity in twins. Indian J Ophthalmol 2010;58:209–211.
2012;171:887–893.
2. Domanico R, Davis DK, Coleman F, Davis BO. Documenting the NICU design dilemma: Comparative patient
progress in openward and single family room units. J
Perinatol 2011;31:2818.
3. Hellstrm A, Smith LE, Dammann O. Retinopathy of prematurity. Lancet 2013;382:144557.
4. Good WV, Hardy RJ, Dobson V, Palmer EA, Phelps DL, Quintos M, et al. The incidence and course of retinopathy
of prematurity: Findings from the early treatment for retinopathy of prematurity study. Pediatrics 2005;116:15–
23.
5. Dai AI, Demiryürek S, Aksoy SN, Perk P, Saygili O, Güngör K. Maternal iron deficiency anemia as a risk factor for the development of retinopathy of prematurity. Pediatr Neurol 2015;53:146–150.
6. Port AD, Paul Chan RV, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity: insights
from outlier infants. Graefes Arch Clin Exp Ophthalmol 2014;252:1669–1677.
7. Palmer EA, Flynn JT, Hardy RJ, Phelps DL, Phillips CL, Schaffer DB, et al. Incidence and early course of
retinopathy of prematurity. The cryotherapy for retinopathy of prematurity cooperative group. Ophthalmology
1991;98:1628–1640.
8. Bossi E, Koerner F, Flury B, Zulauf M. Retinopathy of prematurity: A risk factor analysis with univariate and
multivariate statistics. Helv Paediatr Acta 1984;39:307– 317.
9. Yin H, Li XX, Li HL, Zhang W. Incidence and risk factor analysis of retinopathy of prematurity. Zhonghua Yan Ke
Za Zhi 2005;41:295–299.
10. Chattopadhyay MP, Pradhan A, Singh R, Datta S. Incidence and risk factors for retinopathy of prematurity in neonates. Indian Pediatr 2015;52:157.
11. Chen Y, Xun D, Wang YC, Wang B, Geng SH, Chen H, et al. Incidence and risk factors of retinopathy of prematurity in two neonatal Intensive Care Units in North and South China. Chin Med J 2015;128:914–918.
12. Liu Q, Zin Z, Ke N, Chen L, Chen XK, Fang J, et al. Incidence of retinopathy of prematurity in Southwestern China and analysis of risk factors. Med Sci Monit 2014;20:1442–1451.
13. Seiberth V, Linderkamp O. Risk factors in retinopathy of prematurity: A multivariate statistical analysis. Ophthalmologica 2000;214:131–135.
14. Larsson E, Carle-Petrelius B, Cernerud G, Ots L, Wallin A, Holmstrom G. Incidence of ROP in two consecutive
Swedish population based studies. Br J Ophthalmol 2002;86:1122–1126.
15. Saeidi R, Hashemzadeh A, Ahmadi S, Rahmani S. Prevalence and predisposing factors of retinopathy of prematurity in very low-birth-weight infants discharged from NICU. Iran J Pediatr 2009;19:59–63.
16. Mohamed S, Murray JC, Dagle JM, Colaizy T. Hyperglycemia as a risk factor for the development of retinopathy of prematurity. BMC Pediatr 2013;13:78.
17. Mutlu FM, Altinsoy HI, Mumcuoglu T, Kerimoglu H, Kilic S, Kul M, et al. Screening for retinopathy of prematurity in a tertiary care newborn unit in Turkey: Frequency, outcomes, and risk factor analysis. J Pediatr Ophthalmol Strabismus 2008;45:291–298.
18. Kim J, Jin JY, Kim SS. Postnatal weight gain in the first two weeks as a predicting factor of severe retinopathy of prematurity requiring treatment. Korean J Pediatr 2015;58:52–59.
19. Khalesi N, Shariat M, Fallahi M, Rostamian G. Evaluation of risk factors for retinopathy in preterm infant: A case-control study in a referral hospital in Iran. Minerva Pediatrica 2015;67:231–237.
20. Weintraub Z, Carmi N, Elouti H, Rumelt S. The association between stage 3 or higher retinopathy of prematurity and other disorders of prematurity. Can J Ophthalmol 2011;46:
419.
21. Yau GS, Lee JW, Tam VT, Liu CC, Wong IY. Risk factors for retinopathy of prematurity in extremely preterm Chinese infants. Medicine (Baltimore) 2014;93:e314.
22. Fortes Filho JB, Eckert GU, Procianoy L, Barros CK, Procianoy RS. Incidence and risk factors for retinopathy of
prematurity in very low and in extremely low birth weight infants in a unit-based approach in southern Brazil. Eye 2009;23:25–30.
23. Kumar P, Sankar MJ, Deorari A, Azad R, Chandra P, Agarwal R, et al. Risk factors for severe retinopathy of
prematurity in preterm low birth weight neonates. Indian J Pediatr 2011;78:812–816.
24. Fortes Filho JB, Borges Fortes BG, Tartarella MB, Procianoy RS. Incidence and main risk factors for severe
retinopathy of prematurity in infants weighing less than 1000 grams in Brazil. J Trop Pediatr 2013;59:502–506.
25. Celebi ARC, Petricli IS, Hekimoglu E, Demirel N, Bas AY. The incidence and risk factors of severe retinopathy of
prematurity in extremely low birth weight infants in Turkey. Med Sci Monit 2014;20:1647–1653.
26. Gschlieer A, Stifter E, Neumayer T, Moser E, Papp A, Dorner G, et al. Twin-twin transfusion syndrome as a
possible risk factor for the development of retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol
2015;253:151–156.
27. Yau GS, Lee JW, Tam VT, Yip S, Cheng E, Liu CC, et al. Differences in risk factors for retinopathy of prematurity
development in paired twins: A Chinese population study. Sci World J 2014;2014:212183.
28. Azad R, Chandra P, Patwardhan SD, Gupta A. Profile of asymmetrical retinopathy of prematurity in twins. Indian J Ophthalmol 2010;58:209–211.