ABSTRACT
Objective To analyze the risk factors of aggressive posterior retinopathy of prematurity (AP-ROP). Methods A retrospective case-control study was applied. Questionnaire was designed through literature research to collect data of AP-ROP and ordinary ROP(except for AP-ROP)from March,2012 to September, 2014 in the department of neonatology in Guangdong Women and Children′s Hospital. Based on the ratio of 1:2 , the two groups were selected with the matching conditions:the closest date of admission in hospital,ordinary ROP children,collection and analysis of the data. Results Univariate analysis:gestational age(P<0.05),birth weight(P<0.05),oxygen therapy days(P<0.05),days of mechanical ventilation(P<0.05),gestational age<32 w(P<0.05),birth weight<1250 g(P<0.05),oxygen(P<0.05),oxygen≥14 d(P<0.05),mechanical ven-tilation(P < 0.05),mechanical ventilation ≥ 14 d(P < 0.05),PS(P < 0.05),neonatal anemia(P < 0.05), blood transfusion≥2 times(P<0.05),RDS(P<0.05),neonatal pneumonia(P<0.05),apnea(P<0.05), BPD(P < 0.05),intracranial hemorrhage(P < 0.05),metabolic acidosis(P < 0.05),and retinal hemorrhage (P < 0.05) were related to AP-ROP. Multivariate analysis with conditional logistic regression analysis indicated that blood transfusion ≥2 times(OR:14.956,95%CI:4.328~51.684)and apnea(OR:7.590,95%CI:2.507~22.978)were regarded as the independent risk factors for AP-ROP. Conclusions AP-ROP is associated with low gestational age,low birth weight,oxygen therapy and related complications including RDS and retinal hemorrhage. Blood transfusion and apnea are important independent risk factors of AP-ROP.
ABSTRACT
Objective To investigate the present situation of retinopathy of the prematurity(ROP)in Guang-dong Province.Methods A total of 1 52 hospitals engaged in neonatal medical service were selected from 1 3 cities in Guangdong Province by stratified random sampling method.The questionnaires of present situation and influential factors for ROP in Guangdong Province were distributed to the hospital officers to survey the special equipment in the Neonato-logy Department,ROP specialists and their training collected,the collected related equipment and the present situation of the disease,et al.Eventually,1 22 questionnaires was collected,and the return rate was 80.26%.One hundred and twenty -two hospitals entered into the study,including 50 tertiary hospitals,72 secondary and primary hospitals.Statisti-cal analysis was done with SPSS 1 9.0.Results Tertiary hospitals were better than secondary and primary hospitals in terms of conducting the oxygen monitoring (χ2 =1 8.639,P <0.01 ),ROP screening (χ2 =40.054,P <0.01 )and ROP treatment(χ2 =8.262,P <0.05).The restriction factors in the present situation of ROP were lack of specialists,tech-nology and equipment,especially the first two factors.The difference in lack of specialists and technology between tertia-ry hospitals and the lower -level hospitals was significant(χ2 =4.520,P <0.05).There were 63 hospitals able to con-duct ROP screening,and 1 6 hospitals without equipment could carry out ROP screening through referral or inviting the experts from other hospitals.Fifty -nine hospitals which couldn′t carry out ROP screening had to refer patients to other hsopitals or invite the experts from other hospitals for consultation of high risk patients.Conclusions The present situation of ROP in the tertiary hospitals in Guangdong Province is generally satisfactory,while that in the secondary and primary hospitals stays behind.The constraints for present situation of ROP examination and treatment were lack of spe-cialists,technology and equipment.The hospitals that can′t implement ROP screening should establish regional co -operation by referral and resource sharing to improve the present situation of ROP in Guangdong Province.