Prevalence and risk factors of retinopathy of prematurity

Cut Badriah; Idham Amir; Elvioza Elvioza; Evita Ifran

doi:10.14238/pi52.3.2012.138-44

Cut Badriah Department of Child Health, University ofIndonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Idham Amir Department of Child Health, University ofIndonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Elvioza Elvioza Department of Ophtalmology, University ofIndonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Evita Ifran Department of Child Health, University ofIndonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta

DOI: https://doi.org/10.14238/pi52.3.2012.138-44

Keywords: retinopathy of prematurity, risk factors

Abstract

Background Retinopathy of prematurity (ROP) is the main cause
of visual impairment in premature infants. Due to advances in
neonatal care, the increased survival of extremely low birth weight
(ELBW) infants in recent years has produced a population of
infants at very high risk of ROP.
Objective The aims of this study were to determine the
prevalence and potential risk factors for ROP.
Methods This retrospective study was conducted at the
Neonatalogy Ward, Cipto Mangunkusumo Hospital, from
January 2005 to August 2010. We included all premature
infants of gestational age (GA) < 37 weeks, body weight
(BW) not exceeding 2000 grams, as well as those who had
eye examinations and complete medical records. Risk factors
such as GA, BW, duration of oxygen (Oz) therapy, sepsis, and
red blood cell (RBC) transfusion were analyzed using the Chiô€€»
square and logistic regression tests. Pediatric ophthalmologists
had performed eye examinations on all infants. ROP was graded
according to the International Classification of ROP.
Results The prevalence of ROP and of stage 3 or greater
ROP was 11.9% and 4.8% of all subjects, respectively. Body
weight, GA, duration of Oz therapy, and sepsis were found to
be associated with the development ofROP. However, stepwise
logistic regression analysis revealed that only BW of:s 1000
g [odds ratio (OR) 10.88; 95% CI 3.09 to 38.31; P < 0.000],
02 therapy 2: 7 days (OR 5.56; 95% CI 1.86 to 16.58; P <
0.0001), and GA of oS 28 weeks (OR 4.26; 95% CI 1.15 to
15.81; P = 0.030) were statistically significant risk factors for
ROP. The equation obtained was y ô€€ƒ -4.092 + 2.388 (BW)
+ 1.451 (GA) + 1.716 (duration of 02 therapy). The model
showed good calibration (a nonô€€»significant Hosmerô€€»Lemeshow
test; P = 0.816) and discriminative ability. The area under
the curve (AUC) value was 92.2% (95% CI 0.867 to 0.976;
P < 0.0001).
Conclusion Prevalence ofROP in this study (11.9%) was lower
than that of previous studies. By regression logistic analysis, the
main risk factors for development ofROP were BW of:s 1000
g, Oz therapy 2: 7 days, and GA :s 28 weeks. The probability of
ROP occurrence increased v.ith greater number of risk factors.
[Paediatr rndones. 2012;52:138-44].

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