A comparative analysis of the frequency and severity of active retinopathy of prematurity depending on the degree of maturity of the child for 2009–2011 and 2012–2014 in the neonatal center of St. Petersburg

Abstract

Aim: The aim of this retrospective comparative analysis is to compare the frequency and severity of manifestations of retinopathy of prematurity (ROP) depending on the gestational age (GA) of patients in the neonatal center of St. Petersburg for 2009–2011 and 2012–2014.

Materials and methods: From 2009 to 2014, we observed 1801 premature babies at risk for ROP with a GA of 22–32 weeks (average, 28.0 ± 2.1 weeks). Of these, 415 children (23%) were born at the extreme gestational term (GA ≤ 26 weeks). Regarding the period of hospital stay, the studied patients were divided into two groups: group 1 had 785 children with GA of 23–32 weeks (average, 27.9 ± 1.8 weeks) for 2009–2011, and group 2 had 1016 children with GA 22–32 weeks (average, 28 ± 2.3 weeks) for 2012–2014. The screening and monitoring for ROP were performed in accordance with federal clinical guidelines.

Results: The frequency of ROP in deeply premature infants over the years of observation increased by 31.4%, from 42.8% to 74.2%. ROP prevailed in children with GA 22–26 weeks (92%) compared with more mature (GA 27–32 weeks) newborns–(59.2%). Also, the threshold stages of the disease (Type 1 ROP) developed more often among children (28.9%) with GA up to 27 weeks, and only in 7.1% of cases in children with GA 27–32 weeks. In addition, the number of adverse outcomes in children with stages 3–4 ROP was 4.3% and 1.1%, respectively). This indicator was affected by a significant increase (by 11.4%) in the survival of children with GA 22–24 weeks. At the same time, in children with GA 27–32 weeks, this indicator remained stable for six years.

Conclusion: An increase in the survival rate of deeply premature babies with GA of 22–26 weeks was expected to lead not only to an increase in the incidence of ROP, but also to its severe stages (by 12.2%) and, as a result, an increase in the level of visual impairment from early childhood.

Keywords

retinopathy of prematurity / active phase / gestational age

References

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