The prevalence of retinopathy of prematurity in very low birth weight newborn infants

OBJECTIVE: To evaluate the prevalence of retinopathy of prematurity and the risk factors affecting very low birth weight infants at a neonatal intensive care unit. METHODS: A cross-sectional study investigating all newborn infants with birth weights > 1,500 g and/or gestational ages > 32 weeks, admitted to the Neonatal ICU at the Hospital de Clínicas de Porto Alegre, from October 2002 to March 2004. Patients underwent indirect binocular ophthalmoscopy of the fundus at six weeks postpartum. Infants who progressed to threshold disease were given laser therapy. RESULTS: One hundred and fourteen newborn infants were studied. Eighty-three patients were not diagnosed with retinopathy of prematurity, 18 had stage I retinopathy of prematurity, seven stage II retinopathy of prematurity and six patients had threshold retinopathy of prematurity. The prevalence of retinopathy of prematurity was 27.2% (95% CI: 19.28-36.32) affecting 31 newborn infants, and the prevalence of retinopathy of prematurity progressing to threshold disease was 5.26% (95% CI: 1.96-11.10), affecting six patients. Retinopathy of prematurity was confirmed in 50% of the patients with weights below 1,000 g and 71.5% of newborn infants born at gestational ages of less than 28 weeks. Gestational age and birth weight were significantly lower among patients with retinopathy of prematurity than among those without. CONCLUSIONS: Although the results of this study demonstrate that the observed prevalence was similar to that described in literature, this ROP frequency remains elevated among very low birth weight infants. The development of retinopathy of prematurity was inversely proportional to weight and gestational age at birth.

Prevalência da retinopatia da prematuridade no Centro de Neonatologia do Hospital de Clínicas de Porto Alegre / Prevalence of retinopathy of prematurity at the Neonatal Intensive Care Unit at Hospital de Clínicas de Porto Alegre, Brazil

Objetivo: Estudar a prevalência da retinopatia da prematuridade em recém-nascidos prematuros, nascidos no Hospital de Clínicas de Porto Alegre entre outubro de 2002 e agostode 2005.Métodos: Estudo transversal de 220 crianças prematuras nascidas com peso igual ouinferior a 1.500 gramas e/ou com idade gestacional igual ou menor do que 32 semanas,examinadas no centro de neonatologia, após dilatação das pupilas, sempre a partir da sextasemana de vida.Resultados: A retinopatia da prematuridade ocorreu em 61 (61/220) prematuros, em um percentual de 27,73%. A doença atingiu estadiamento 1 em 12,73% dos casos (28/220),estadiamento 2 em 9,55% dos casos (21/220) e estadiamento 3 em 5% dos casos (11/220).Apenas uma das crianças atingiu o estadiamento 5 da doença, em 0,45% dos casos (1/220).Conclusões: O percentual de 27,73% de retinopatia encontrado foi similar ao de outros trabalhos internacionais com o mesmo delineamento, assim como o percentual de 5% de retinopatia no estágio 3. Apenas um dos prematuros desenvolveu a doença até o estágio mais grave (5), havendo 0,45% de cegueira pela retinopatia da prematuridade no Hospital de Clínicas de Porto Alegre.

Objective: To evaluate the prevalence of retinopathy of prematurity (ROP) in neonates bornat the Hospital de Clínicas de Porto Alegre, in southern Brazil, from October 2002 to August2005. Methods: Cross-sectional study of 220 neonates born with 1.500 g or less and/or gestational age of 32 weeks or less. They were all assessed at the division of neonatology, after pupil dilatation, starting from the sixth week of life.Results: ROP was diagnosed in 61 neonates (61/220), with a prevalence rate of 27.73%.The disease reached stage 1 ROP in 12.73% (28/220), stage 2 ROP in 9.55% (21/220), and stage 3 ROP in 5.00% (11/220) of the cases. Only one child reached stage 5 ROP, which represented 0.45% of the cases (1/220). Conclusions: The ROP prevalence of 27.73% was similar to other international crosssectionalstudies, as well as 5% of stage 3 ROP. Only one of the neonates reached the most severe stage of the disease (ROP5), with blindness by ROP rate of 0.45% at the Hospital de Clínicas de Porto Alegre.

Influência do diagnóstico pré-natal de malformaçäo fetal no vínculo mäe-feto / Influence of prenatal diagnosis of fetal malformation in the mother-fetal attachement

O objetivo deste trabalho foi investigar os sentimentos que o diagnóstico pré-natal de malformação fetal desperta na mãe, bem como o vínculo mãe-feto, com o objetivo de que a própria equipe de saúde saiba como lidar com tais situações e possa auxiliar os pais a estabelecerem uma melhor relação com o feto, favorecendo a adesão ao tratamento proposto