Incidenceand Risk Factorsof the Retinopathy of Prematurity |
June Dong Park1, Jung Hae Kweon1, Woong Heum Kim2, Beyong Il Kim2, Jung-Hwan Choi2, Chong Ku Yun2, Sang In Khwarg3, Young Suk Yu3 |
1Department of Pediatrics , Seoul National University College of Medicine, Seoul, Korea 2Department of Pediatrics Seoul National University College of Medicine, Seoul, Korea 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea |
미숙아 망막증의 발병빈도 및 주산기 위험인자 |
박준동1, 권정혜1, 김응흠2, 김병일2, 최중환2, 윤종구2, 곽상인3, 유영석3 |
1서울대학교 의과대학 소아과학교실 2서울대학교 의과대학 소아과학교실 3서울대학교 의과대학 안과학교실 |
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Abstract |
Purpose : Retinopathy of prematurity(ROP) continues to be a serious problem in infants who survived with neonatal intensive care. Nevertheless, there is neither available data about the incidence of ROP which may be the basis of the epidemiology, nor analysis of the risk factors of ROP in Korea. The purpose of this retrospective study was to evaluate the incidence of ROP and to analyze perinatal risk factors of ROP.
Methods : The study population was inborn neonates of Seoul National University Hospital during the three-year period, from Jan. 1991 to Dec. 1993. The total number of infants was 5,764, and the incidence of ROP was evaluated according to gestational age and birthweight. Infants with birthweight under 1,500gram or with gestational age less than 33 weeks were involved in this study, in 168 of the 242 infants, their eyes were examined. Of these, 71 developed some degree of ROP, and 12 received cryotherapy. The comparisons of perinatal risk factors of ROP between the group with and without ROP, and in the group with ROP, between with and without cryotherapy have been made.
Results :
1) The cumulative incidence of ROP according to gestational age was 100% in less than 28 weeks, 96.0%, 80.4%, 66.7%, 57.3%, 44.1%, 32.2%, 23.1%, 15.8%, and 10.6% in less than 29, 30, 31, 32, 33, 34, 35, 36, and 37 weeks, respectively.
2) The cumulative incidence of ROP according to birthweight was 100% in under 750gram, 90.9%, 69.8%, 56.8%, 39.1%, 26.8%, 16.0%, and 9.9% in under 1,000gram, 1,250gram, 1,500gram, 1,750gram, 2,000gram, 2,250gram, and 2,500gram, respectively.
3) The perinatal risk factors which were statistically significant were gestational age, birthweight, Apgar score at 1 and 5 minutes, duration of hospitalization, ventilation and oxygen supply, number of transfusions, acidosis, hyperoxia, maximum fraction of inspired oxygen, maximum peak inspiratory pressure, maximum frequency, and the presence of pneumonia, apnea-bradycardia syndrome, intraventricular hemorrhage, sepsis, hypocalcemia, hyperglycemia, bronchopulmonary dysplasia, administration of aminophylline or furosemide. With linear logistic regression analysis, only gestational age (OR=0.930, 95% CI=0.887-0.975) and hyperoxia
(OR=1.006, 95% CI=1.003-1.009) were proved to relate to the occurrence of ROP independently.
Conclusion : ROP was developed in 44.1% of infants less than 33 weeks and in 56.8% of infants under 1,500gram and the occurrence of ROP was related significantly only to gestational age and hyperoxia. |
Key Words:
Retinopathy of prematurity, Incidence, Perinatal risk factors |
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