Acta paediatrica (Oslo, Norway : 1992) · 2025
Population-Based Cohort Study for Development of National Retinopathy of Prematurity Screening Criteria.
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Gerull R, Sanchez C, Atkinson A, Schuler-Barazzoni M, Adams M, Barcos Munoz F, Gerth-Kahlert C, Schulzke S M, Swiss Neonatal Network
Аннотация
AIM: Screening criteria for retinopathy of prematurity (ROP) vary among countries. Early detection of ROP and minimising the burden of screening are important.
METHODS: We analysed data from very preterm infants born in Switzerland between 2006 and 2022. Logistic regression models were fitted to evaluate 17 potential risk factors for ROP treatment.
RESULTS: 168/11354 patients (median (range) gestational age (GA) 29.6 (23.0-31.9) weeks) required ROP treatment. All would have been detected and screening burden would have been reduced by 56% if screening had required meeting ≥ 1 of the following criteria: GA < 27 weeks (89.3%), birth weight < 1000 g (97.0%), intraventricular haemorrhage≥II° (24.0%), congenital tumour (1.2%). We identified six statistically significant risk factors for ROP: GA (adjusted odds ratio (aOR) 0.46, 95% CI 0.40-0.52, p < 0.001), birth weight z-score (aOR 0.58, 95% CI 0.46-0.73, p < 0.001), duration of supplemental oxygen (aOR 1.01 95% CI 1.01-1.02, p < 0.001), duration of mechanical ventilation (OR 1.01, 95% CI 1.00-1.02, p = 0.018), caesarean section (OR 1.84, 95% CI 1.06-3.36, p = 0.038), and congenital tumour (OR 26.3, 95% CI 2.71-189, p = 0.002). The model allowed for excellent prediction of ROP treatment (AUC 0.963, 95% CI 0.944-0.981).
CONCLUSIONS: Safely reducing the burden of ROP screening appears achievable in Switzerland.
METHODS: We analysed data from very preterm infants born in Switzerland between 2006 and 2022. Logistic regression models were fitted to evaluate 17 potential risk factors for ROP treatment.
RESULTS: 168/11354 patients (median (range) gestational age (GA) 29.6 (23.0-31.9) weeks) required ROP treatment. All would have been detected and screening burden would have been reduced by 56% if screening had required meeting ≥ 1 of the following criteria: GA < 27 weeks (89.3%), birth weight < 1000 g (97.0%), intraventricular haemorrhage≥II° (24.0%), congenital tumour (1.2%). We identified six statistically significant risk factors for ROP: GA (adjusted odds ratio (aOR) 0.46, 95% CI 0.40-0.52, p < 0.001), birth weight z-score (aOR 0.58, 95% CI 0.46-0.73, p < 0.001), duration of supplemental oxygen (aOR 1.01 95% CI 1.01-1.02, p < 0.001), duration of mechanical ventilation (OR 1.01, 95% CI 1.00-1.02, p = 0.018), caesarean section (OR 1.84, 95% CI 1.06-3.36, p = 0.038), and congenital tumour (OR 26.3, 95% CI 2.71-189, p = 0.002). The model allowed for excellent prediction of ROP treatment (AUC 0.963, 95% CI 0.944-0.981).
CONCLUSIONS: Safely reducing the burden of ROP screening appears achievable in Switzerland.