TY - JOUR

T1 - Neonatal Risk Factors for Treatment-Demanding Retinopathy of Prematurity

T2 - A Danish National Study

AU - Slidsborg, Carina

AU - Jensen, Aksel

AU - Forman, Julie Lyng

AU - Rasmussen, Steen

AU - Bangsgaard, Regitze

AU - Fledelius, Hans Callø

AU - Greisen, Gorm

AU - la Cour, Morten

N1 - Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PY - 2016/4

Y1 - 2016/4

N2 - PURPOSE: One goal of the study was to identify "new" statistically independent risk factors for treatment-demanding retinopathy of prematurity (ROP). Another goal was to evaluate whether any new risk factors could explain the increase in the incidence of treatment-demanding ROP over time in Denmark.DESIGN: A retrospective, register-based cohort study.PARTICIPANTS: The study included premature infants (n = 6490) born in Denmark from 1997 to 2008.METHODS: The study sample and the 31 candidate risk factors were identified in 3 national registers. Data were linked through a unique civil registration number. Each of the 31 candidate risk factors were evaluated in univariate analyses, while adjusted for known risk factors (i.e., gestational age [GA] at delivery, small for gestational age [SGA], multiple births, and male sex). Significant outcomes were analyzed thereafter in a backward selection multiple logistic regression model.MAIN OUTCOME MEASURES: Treatment-demanding ROP and its associations to candidate risk factors.RESULTS: Mechanical ventilation (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.99-4.08; P < 0.01) and blood transfusion (OR, 1.97; 95% CI, 1.20-3.14; P = 0.01) were the only new statistically independent risk factors, in addition to GA at delivery, SGA, multiple births, and male sex. Modification in these prognostic factors for ROP did not cause an increase in treatment-demanding ROP.CONCLUSIONS: In a large study population, blood transfusion and mechanical ventilation were the only new statistically independent risk factors to predict the development of treatment-demanding ROP. Modification in the neonatal treatment with mechanical ventilation or blood transfusion did not cause the observed increase in the incidence of preterm infants with treatment-demanding ROP during a recent birth period (2003-2008).

AB - PURPOSE: One goal of the study was to identify "new" statistically independent risk factors for treatment-demanding retinopathy of prematurity (ROP). Another goal was to evaluate whether any new risk factors could explain the increase in the incidence of treatment-demanding ROP over time in Denmark.DESIGN: A retrospective, register-based cohort study.PARTICIPANTS: The study included premature infants (n = 6490) born in Denmark from 1997 to 2008.METHODS: The study sample and the 31 candidate risk factors were identified in 3 national registers. Data were linked through a unique civil registration number. Each of the 31 candidate risk factors were evaluated in univariate analyses, while adjusted for known risk factors (i.e., gestational age [GA] at delivery, small for gestational age [SGA], multiple births, and male sex). Significant outcomes were analyzed thereafter in a backward selection multiple logistic regression model.MAIN OUTCOME MEASURES: Treatment-demanding ROP and its associations to candidate risk factors.RESULTS: Mechanical ventilation (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.99-4.08; P < 0.01) and blood transfusion (OR, 1.97; 95% CI, 1.20-3.14; P = 0.01) were the only new statistically independent risk factors, in addition to GA at delivery, SGA, multiple births, and male sex. Modification in these prognostic factors for ROP did not cause an increase in treatment-demanding ROP.CONCLUSIONS: In a large study population, blood transfusion and mechanical ventilation were the only new statistically independent risk factors to predict the development of treatment-demanding ROP. Modification in the neonatal treatment with mechanical ventilation or blood transfusion did not cause the observed increase in the incidence of preterm infants with treatment-demanding ROP during a recent birth period (2003-2008).

U2 - 10.1016/j.ophtha.2015.12.019

DO - 10.1016/j.ophtha.2015.12.019

M3 - Journal article

C2 - 26854038

VL - 123

SP - 796

EP - 803

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 4

ER -