Postnatal risk factors of type 1 retinopathy of prematurity in children with a gestational age less than 27 weeks

Aim: The aim of this study is to determine the prognostic significance of postnatal risk factors for Type 1 retinopathy of prematurity (ROP) in children born before 27 weeks of gestation.

Materials and methods: From 2009 to 2014, we observed 239 patients with gestational age (GA) of 22–26 weeks (average, 24.9 ± 1.0 weeks) and birth weight of 490–1200 g (average, 776.9 ± 140.1 g), who subsequently developed ROP. Depending on the stage of active ROP, the children were divided into four groups: group 1 included 83 children with stage 1 of ROP, group 2 included 70 children with stage 2 of ROP, group 3 included 57 newborns with stage 3 of ROP plus disease (threshold), and group 4 consisted of 29 patients with aggressive posterior ROP. Thus, 86 (36%) children in groups 3 and 4 had an unfavorable course — Type 1 ROP. Screening and monitoring of the disease were performed in accordance with federal clinical guidelines.

Results: The development of severe stages of ROP correlated with a decrease in the mean gestational age (p = 0.0002) and birth weight (p = 0.0006). Fifteen risk factors that are associated with the somatic condition of patients with gestational age less than 27 weeks in the postnatal period were studied. The reliability of their significance in the development of Type 1 ROP was determined by the length of stay on mechanical ventilation (more than 45 days), multiple blood transfusions (more than 6), and early surgical treatment of an open ductus arteriosus.

Conclusion: Consideration and correction of identified postnatal risk factors for the development of Type 1 ROP will enable timely prediction and minimize the likelihood of an adverse course of the disease. Therefore, improving the organization and quality of neonatal care for children with gestational age less than 27 weeks could prevent the development of severe forms of ROP.