J Korean Soc Neonatol.  2012 May;19(2):71-76. 10.5385/jksn.2012.19.2.71.

Risk of Surgery for Retinopathy of Prematurity in Very Low Birth Weight Infants

• Kim NH
• Lee SM
• Eun HS
• Park MS
• Park KI
• Namgung R
• Lee C

• KMID: 2188400
• DOI: http://doi.org/10.5385/jksn.2012.19.2.71

Abstract

PURPOSE
The main postnatal risk factors of retinopathy of prematurity (ROP) were described as prolonged oxygen therapy and lower gestational age. Recent data suggest poor early weight gain during the first weeks of life, which can be an additional predictor of severe ROP. We aimed to analyze the risk factors associated with requiring operation for ROP in preterm infants with very low birth weight (VLBW).
METHODS
In a retrospective case control study, from January 2004 to June 2010, 140 VLBW infants diagnosed as ROP by the International classification of ROP were recruited. There were 14% of infants with stage 1 disease, 65.7% stage 2, and 20% stage 3 or more. A group requiring a laser surgery for ROP was 66 infants, and a group not requiring surgery was 74 infants.
RESULTS
By a univariate analysis, antenatal steroid, chorioamnionitis, gestational age, birth weight, days on oxygen, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalasia and sepsis were significantly associated with ROP requiring surgery. Weight differences between birth and each from 4 to 12 weeks were significantly lower in the infants requiring surgery (P<0.05). However, after adjustment for gestational age in logistic regression, weight difference between birth and 8th week was a significant predictive factor for the requirement of surgery in infants with ROP (OR, 0.998; 95% CI, 0.996-0.999, P=0.013).
CONCLUSION
We suggest that careful monitoring of weight change and aggresive nutritional support for poorly growing infants, during the first 8 weeks of life, may possibly prevent laser surgery of ROP in preterm VLBW infants.

Keyword

ROP; Risk factor; Weight gain; VLBW

MeSH Terms

Birth Weight
Bronchopulmonary Dysplasia
Case-Control Studies
Chorioamnionitis
Diterpenes
Female
Gestational Age
Hemorrhage
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Laser Therapy
Logistic Models
Nutritional Support
Oxygen
Parturition
Pregnancy
Retinopathy of Prematurity
Retrospective Studies
Risk Factors
Sepsis
Weight Gain
Diterpenes
Oxygen