EPOS
European Paediatric Ophthalmological Society
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The main risk factors for IV-V stages of Retinopathy of Prematurity
FOMINA NATALYA 1, SAIDACHEVA ELVIRA 11St.Petersburg's Medical Pediatric Academy
Purpose: To identify the risk factors for ROP severity (IV-V stages) Methods: Since November 2000 to February 2002 we had 6 babies with IV-V stages of ROP. During this period of time 875 premature infants had been treated at the hospital. The morbidity of ROP was 13,1% and the morbidity of IV-V stages of ROP - 0,7%. All 6 babies were born at gestational age from 26 to 30 weeks (mean 28 w), birth weight between 790 grams - 1450 grams (mean 1100 g). All examined babies received oxygen therapy during more than 30 days, 2 babies - during 87 and 105 days. 100% of babies had serious episodes of apnea from 7 to 72 days of life. The main diagnosis of babies with severe ROP were intrauterine infection and pneumonia (83%), cerebral hemorrhage (67%) and hydrocephalic (33%). Results: ROP has been developed at 30-38 weeks post conceptional age or 4,5 to 10 weeks after birth. All babies had a zone I "plus" disease. 67% infants had a hemophthalmia. 3 babies were treated by diode laser and 3 babies were not treated because of acuty of underlying disease. The lasercoagulation was performed at 9-14 weeks after birth but all cases progressed to stage IV-V despite treatment. Unfavorable risk factors of severe ROP development: social factors - 50% of mothers didn't visit a gynecologist during pregnancy; poverty and low income - 50% of women; prior medical abortions (50%); prior spontaneous abortion (33%); uterine bleeding (17%). Conclusion: The main risk factors of severe ROP were social factors. Short gestational age, low birth weight, long period of oxygen therapy all were associated with severity of ROP. "Plus" disease and zone I involvement are important prognostic factors.