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

Kim,  Nam Hyo; Lee,  Soon Min; Eun,  Ho Sun; Park,  Min Soo; Park,  Kook In; Namgung,  Ran; Lee,  Chul

doi:2012.19.2.71

Neonatal Med > Volume 19(2); 2012 > Article

Original Article

Journal of the Korean Society of Neonatology 2012;19(2):71-76.
DOI: https://doi.org/10.5385/jksn.2012.19.2.71 Published online May 31, 2012.

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

Nam Hyo Kim, Soon Min Lee, Ho Sun Eun, Min Soo Park, Kook In Park, Ran Namgung, Chul Lee

Division of Neonatology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. Ranng@yuhs.ac

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.

Key Words: ROP; Risk factor; Weight gain; VLBW