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

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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.

About the authors

Elvira I. Saidasheva

North-Western State Medical University named after I.I. Mechnikov; Children’s city multidisciplinary clinical specialized center for high medical technologies

Author for correspondence.
Email: esaidasheva@mail.ru
ORCID iD: 0000-0003-4012-7324

MD, PhD, Professor

Russian Federation, 191015, Saint Petersburg; 198205, Saint Petersburg

Svetlana V. Buyanovskaya

North-Western State Medical University named after I.I. Mechnikov; Children’s city multidisciplinary clinical specialized center for high medical technologies

Email: esaidasheva@mail.ru
ORCID iD: 0000-0001-7503-2611

MD

Russian Federation, 191015, Saint Petersburg; 198205, Saint Petersburg

Fedor V. Kovshov

Children’s city multidisciplinary clinical specialized center for high medical technologies

Email: esaidasheva@mail.ru
ORCID iD: 0000-0001-6039-1398

MD

Russian Federation, 198205, Saint Petersburg

References

  1. Katargina LA. Retinopathy of prematurity, modern state of the problem and targets of the eye are organization to premature babies in the Russian Federation. Russian Pediatric Ophthalmology. 2012;(1):5-7. (in Russian)
  2. Saidasheva EI, Gorelik YuV, Buyanovskaya SV, Kovshov FV. Retinopathy of prematurity: the course and results of treatment in children with gestational age less than 27 weeks. Russian Pediatric Ophthalmology. 2015;10(2):28-32. (in Russian)
  3. Saidasheva EI, Buyanovskaya SV, Kovshov FV, Levadnev YuV. The modern approaches to diagnosis and laser treatment of aggressive posterior retinopathy of prematurity. Vestnik Severo-Zapadnogo gosudarstvennogo meditsinskogo universiteta im. I.I. Mechnikova. 2017;9(1):42-7. (in Russian)
  4. Federal clinical guidelines «Diagnostics, monitoring, and treatment of the active phase of retinopathy in premature» (national protocol). Russian Pediatric Ophthalmology. 2015;10(1):54-60. (in Russian)
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  6. Holmström G, Hellström A, Jakobsson P, et al. Five years of treatment for retinopathy of prematurity in Sweden: results from SWEDROP, a national quality register. Br. J. Ophthalmol. 2016;100(12):1656-61. doi: 10.1136/bjophthalmol-2015-307263.
  7. Isaza G, Arora S, Bal M, Chaudhary V. Incidence of retinophaty of prematurity and risk factors among premature infants at a neonatal intensive care unit in Canada. J. Pediatr. Ophthalmol. Strabismus. 2013;50(1):27-32. doi: 10.3928/01913913-20121127-02.
  8. Smith PB, Ambalavanan N, Li L, et al. Approach to infants born at 22 to 24 weeks’ gestation: relationship to outcomes of more-mature infants. Pediatrics. 2012;129(6):e1508-16. doi: 10.1542/peds.2011-2216.

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. The structure of patients with ROP, depending on the gestational age for the observation periods ROP – Retinopathy of Prematurity

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3. Fig. 2. Comparative dynamics of the frequency of active ROP depending on the stage in premature infants with GA 22–26 weeks during the observation periods. ROP – Retinopathy of Prematurity

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4. Fig. 3. Comparative dynamics of the frequency of active ROP depending on the stage in premature infants with GA 27–32 weeks during the observation periods. ROP — Retinopathy of Prematurity

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