Neonatal Risk Factors Associated With Retinopathy of Prematurity
DOI:
https://doi.org/10.52783/jns.v14.1873Keywords:
Retinopathy of Prematurity (ROP), Neonatal Risk Factors, Multiple Gestation, Blood Transfusion, Phototherapy, Family HistoryAbstract
Background: Retinopathy of prematurity, or ROP, is one of the major causes of childhood blindness. Most cases of ROP occur in premature infants, and several neonatal and demographic factors have been linked to the disease, although their relative importance is still being investigated. Knowledge regarding these risk factors is needed to produce effective prevention and treatment plans. This study aimed to identify neonatal risk factors linked to ROP.
Methodology: A case-control study was conducted at the Institute of Ophthalmology, Mayo Hospital Lahore. A total of 94 premature infants, with a gestational age of 37 weeks or less and a birth weight of ≤2500 g, were included, comprising 47 cases and 47 controls. Both groups were matched for age and gender. Data relating to gestation age, birth weight, and neonatal risk factors (neonatal sepsis, oxygen supplementation, blood transfusion, mechanical ventilation, respiratory infection history, ROP family history, multiple gestation) was ascertained on the questionnaire and subjected to Statistical Package for Social Sciences (SPSS) version 26.0 analysis.
Results: Significant risk factors in the study for developing ROP were multiple gestations, blood transfusions, and a family history of ROP with an adjusted odds ratio of 5.27, 9.11, and 12.92, respectively. Phototherapy was a protective factor (adjusted odds ratio = 0.28). The logistic regression model has a relatively good predictive ability with an AUC of 0.746.
Conclusion: This study highlights that multiple gestation, blood transfusion, and a family history of ROP significantly increase the chances of ROP development among premature infants, while phototherapy appears to offer a protective effect. These findings point out the importance of close monitoring and focused therapies for high-risk infants to avoid ROP development.
Downloads
References
Tl T. Extreme prematurity and fibroblastic overgrowth of persistent vascular sheath behind each crystalline lens. I. Preliminary report. Am J Ophthalmol. 1942;25:203-4.
de las Rivas Ramírez N, Luque Aranda G, Rius Díaz F, Pérez Frías FJ, Sánchez Tamayo T. Risk factors associated with Retinopathy of Prematurity development and progression. Sci Rep. 2022;12(1):21977.
Chang JW. Risk factor analysis for the development and progression of retinopathy of prematurity. PLoS ONE. 2019;14(7):e0219934.
Jefferies AL, Society CP, Fetus, Committee N. Retinopathy of prematurity: An update on screening and management. Paediatr Child Health. 2016;21(2):101-4.
Hanif M, Ariff S, Ansar A, Ahmed K, Hussain AS. Characteristics of preterm with sight threatening retinopathy of prematurity. JAMC. 2020;32(2):174-8.
Ali AA, Gomaa NA, Awadein AR, Al‐Hayouti HH, Hegazy AI. Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight, medical conditions and treatment. Acta Paediatr. 2017;106(12):1919-27.
Kim SJ, Port AD, Swan R, Campbell JP, Chan RP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018;63(5):618-37.
Zhu Z, Hua X, Yu Y, Zhu P, Hong K, Ke Y. Effect of red blood cell transfusion on the development of retinopathy of prematurity: A systematic review and meta-analysis. Plos One. 2020;15(6):e0234266.
Boskabadi H, Shoeibi N, Bagheri F, Pourbadakhshan N, Moradi A, Zakerihamidi M. Potential role of bilirubin in preventing retinopathy of prematurity. Curr Pediatr Rev. 2023;19(2):197-202.
Johari M, Karimi A, Mojarad M, Heydari M. Comparative analysis of risk factors for retinopathy of prematurity in single and multiple birth neonates. Int J Retina Vitreous. 2024;10(1):21.
Riazi-Esfahani M, Alizadeh Y, Karkhaneh R, Mansouri M-R, Kadivar M, Ahmadabadi MN, et al. Retinopathy of prematurity: single versus multiple-birth pregnancies. JOVR. 2008;3(1):47.
Onyango O, Sitati S, Amolo L, Murila F, Wariua S, Nyamu G, et al. Retinopathy of prematurity in Kenya: prevalence and risk factors in a hospital with advanced neonatal care. Pan African Medical Journal. 2018;29(1):1-7.
Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child. 2017;102(9):853-7.
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(6):409.
Sabri K, Ells AL, Lee EY, Dutta S, Vinekar A. Retinopathy of prematurity: a global perspective and recent developments. Pediatrics. 2022;150(3).
Johari M, Karimi A, Mojarad M, Heydari M. Comparative analysis of risk factors for retinopathy of prematurity in single and multiple birth neonates. IJRV. 2024;10(1):21.
Tseng H-C, Sung F-C, Mou C-H, Lin HY, Chiang C-C, Hsia N-Y, et al. Population based retrospective cohort study on risk of retinopathy of prematurity in twins. Plos One. 2020;15(3):e0230346.
YENİCE EK, KARA C. Development of Retinopathy of Prematurity in Late Preterm Infants: Singleton or Multiple Pregnancies: Observational and Descriptive Research. Turkiye Klinikleri J Ophthalmol. 2024;33(1):30-5.
Ghirardello S, Dusi E, Cortinovis I, Villa S, Fumagalli M, Agosti M, et al. Effects of red blood cell transfusions on the risk of developing complications or death: an observational study of a cohort of very low birth weight infants. Am J Perinatol. 2017;34(01):88-95.
Wang X, Rao R, Li H, Lei X, Dong W. Red Blood Cell Transfusion for Incidence of Retinopathy of Prematurity: Prospective Multicenter Cohort Study. JMIR Pediatr Parent. 2024;7:e60330.
Uberos J, Fernandez‐Marin E, Campos‐Martínez A, Ruiz‐López A, García‐Serrano JL. Blood products transfusion and retinopathy of prematurity: A cohort study. Acta Ophthalmol. 2023;101(3):e294-e301.
Prasad N, Kumar K, Dubey A. Fetal hemoglobin, blood transfusion, and retinopathy of prematurity in preterm infants: An observational, prospective study. Indian J Ophthalmol. 2023;71(7):2803-7.
Podraza W. A new approach to neonatal medical management that could transform the prevention of retinopathy of prematurity: theoretical considerations. Med Hypotheses. 2020;137:109541.
Englert JA, Saunders RA, Purohit D, Hulsey TC, Ebeling M. The effect of anemia on retinopathy of prematurity in extremely low birth weight infants. Journal of Perinatology. 2001;21(1):21-6.
Hesse L, Eberl W, Schlaud M, Poets C. Blood transfusion: iron load and retinopathy of prematurity. European journal of pediatrics. 1997;156:465-70.
Bizzarro MJ, Hussain N, Jonsson B, Feng R, Ment LR, Gruen JR, et al. Genetic susceptibility to retinopathy of prematurity. Pediatrics. 2006;118(5):1858-63.
Mohamed S, Schaa K, Cooper ME, Ahrens E, Alvarado A, Colaizy T, et al. Genetic contributions to the development of retinopathy of prematurity. Pediatric research. 2009;65(2):193-7.
Port AD, Chan RP, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity: insights from outlier infants. Graefes Arch Clin Exp Ophthalmol. 2014;252:1669-77.
Ortega-Molina J, Anaya-Alaminos R, Uberos-Fernández J, Solans-Pérez de Larraya A, Chaves-Samaniego M, Salgado-Miranda A, et al. Genetic and environmental influences on retinopathy of prematurity. Mediators Infamm. 2015;2015(1):764159.
Lin Y-W, Chen S-N, Muo C-H, Sung F-C, Lin M-H. Risk of retinopathy of prematurity in preterm births with respiratory distress syndrome: a population-based cohort study in Taiwan. Int J Gen Med. 2022:2149-62.
Lin Y-W, Chen S-N, Muo C-H, Sung F-C, Lin M-H. Risk of retinopathy of prematurity in preterm births with respiratory distress syndrome: a population-based cohort study in Taiwan. International Journal of General Medicine. 2022:2149-62.
Bhutani VK, Wong RJ, Turkewitz D, Rauch DA, Mowitz ME, Barfield WD, et al. Phototherapy to Prevent Severe Neonatal Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation: Technical Report. Pediatrics. 2024;154(3).
Kumar PS, Kannan KS, Arunarani R, Ramaswami M, Esther R. A STUDY ON THE RISK FACTORS OF RETINOPATHY OF PREMATURITY. Int J Acad Med Pharm. 2023;5(2):1008-13.
Gulden S, Cervellini G, Colombo M, Marangoni MB, Taccani V, Pesenti N, et al. Hyperbilirubinemia and retinopathy of prematurity: a retrospective cohort study. Eur J Pediatr. 2024:1-10.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
