The Incidence And Risk Factors Related To The Severity Of Retinopathy Of Prematurity

Objective:To retrospectively and analyze the incidence and risk factors related to the severity of retinopathy of prematurity from 2016 to2020 in the second Hospital of Jilin University.Methods:A retrospective study.5782 premature infants hospitalized in the Neonatal intensive Care Unit of the second Hospital of Jilin University from January 2016 to December 2020 were screened by Retcam III.The first screening time was 4-6 weeks after birth or 32 weeks of postmenstrual age.Type 1 ROP were treated with laser or antiVEGF.All children with ROP were followed up to complete vascularization of peripheral retina,while those without complete vascularization were followed up to retrogression or 6 months after birth.The gestational age,birth weight,artificial reproductive technology and maternal age between ROP and non-ROP infants were statistically analyzed.According to the results of screening,patients were divided into ROP treatment group and non-treatment group.At the same time,the related factors such as gestational age,birth weight,concentration of oxygen inhalation,multiple pregnancies,sex,infection,sepsis,blood transfusion,anemia,application of glucocorticoid,gestational hypertension,gestational diabetes,patent ductus arteriosus,hyperbilirubinemia,neonatal pneumonia,necrotizing enterocolitis,fetal distress and assisted reproductive technology were statistically analyzed,and the counting data were tested by non-parametric test.Chi-square test and logistic regression analysis were used to analyze the measurement data.Results:A total of 5782 premature infants were included in this study,of which 2528 met the Chinese screening criteria（gestational age less than 32 weeks or birth weight less than 2000g）.A total of 430 cases of ROP were detected.From 2016 to 2020,the incidence of ROP in premature infants was 3.33%,6.97%,10.71%,7.97% and 9.41%,and the total incidence was 7.44%.The incidence in 2018 and 2020 is higher than that in other years,which may be related to the high birth rate of premature infants under assisted reproduction technology in these two years,and the difference is statistically significant.There were 430 ROP patients,accounting for 7.44% of the total,and 5352 non-ROP premature infants,accounting for 92.56%.There were significant differences in birth weight,gestational age and assisted reproduction between ROP group and non-ROP group.There was no difference in mother’s age between the two groups.There were 337 cases of ROP with complete data,including 103 cases in the treatment group,accounting for 30.56% of the total number of ROP,and 234 cases in the non-treatment group,accounting for 69.44% of the total number of ROP.The average birth weight of the treatment group was 1120（940-1360）g,the average gestational age was 28（28-30）weeks,and the average oxygen inhalation time was70（50-85）days.The average birth weight in the non-treatment group was 1200（1010-1442.5）g,the average gestational age was 29（28-31）weeks,and the average oxygen inhalation time was 55（41-74）days.There were statistical significant in average birth weight,average gestational age,average duration of oxygen inhalation,multiple births and neonatal pneumonia between the treatment group and the non-treatment group.Among them,the duration of oxygen inhalation,multiple births and neonatal pneumonia were the independent risk factors affecting the severity of ROP.There was no statistical significant in sex,infection,septicemia,blood transfusion,anemia,glucocorticoid,gestational hypertension,gestational diabetes,patent ductus arteriosus,hyperbilirubinemia,necrotizing enterocolitis,fetal distress,intracranial hemorrhage and assisted reproduction technology between this two groups（P > 0.05）.Conclusion:1.The incidence of ROP in premature infants in the second Hospital of Jilin University from 2016 to 2020 was 7.44%,and the incidence of ROP under the Chinese screening standard was 17.01%.Among them,the incidence is the highest in 2018 and 2020,which may be related to the application of assisted reproductive technology.2.Gestational age,birth weight and assisted reproductive technology are the risk factors of ROP.3.Birth weight,gestational age,duration of oxygen inhalation,multiple pregnancies and neonatal pneumonia are the risk factors affecting the severity of ROP.