RESUMO
BACKGROUND: Retinopathy of prematurity (ROP) is a leading cause of blindness in children and an ROP epidemic is predicted this decade in sub-Saharan Africa. With the increasing survival rate of preterm babies in Uganda, and no data on ROP prevalence, there is a need to assess the burden of ROP to inform preventive strategies and targeted screening. METHODS: We conducted a two-center cross-sectional study of preterm (< 37 weeks gestational age) infants from the neonatal units of Kawempe National Referral Hospital (KNRH) and Mulago Specialised Women and Neonatal Hospital (MSWNH) from August 2022 to October 2022. An ophthalmologist examined all participants using an indirect ophthalmoscope with a + 20D convex lens and captured digital images using a Volk iNview™ Fundus Camera. The collected data were entered into Epidata 4.2 and exported to Stata 14.0 for analysis. RESULTS: 331 preterm infants enrolled in this study. The oxygen received was unblended. The mean gestational age was 30.4 ± 2.7 weeks, and the mean birth weight was 1597 ± 509 g. 18/101 (17.8%) were found to have any ROP amongst the preterm infants recruited from MSWNH, 1/230 (0.4%) from KNRH [95% CI] had any stage of ROP (i.e. stage 5). Of these, 8 (42.1%) had stage 2 ROP. Infants with a birth weight below 1500 g were 10 times more likely to have ROP than those among infants with a birth weight more than 1500 g [AOR: 10.07 (2.71-37.44)]. Infants who were not fed exclusively on breast milk had higher odds of having ROP than those exclusively fed on breast milk [AOR: 7.82(1.92-31.82)]. CONCLUSION: 6% of preterm infants born in two tertiary hospitals in Uganda were found to have ROP. Lack of exclusive feeding on breast milk and birth weight of less than 1500 g were strong predictors of ROP. The higher prevalence of ROP in MSWNH calls for cautious use of oxygen among preterms. We recommend targeted ROP screening for those at risk.
Assuntos
Recém-Nascido Prematuro , Retinopatia da Prematuridade , Lactente , Criança , Recém-Nascido , Humanos , Feminino , Peso ao Nascer , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/etiologia , Estudos Transversais , Prevalência , Uganda/epidemiologia , Idade Gestacional , Oxigênio , Centros de Atenção Terciária , Encaminhamento e Consulta , Fatores de Risco , Recém-Nascido de muito Baixo PesoRESUMO
BACKGROUND: To analyse the timing of threshold disease in infants requiring treatment for retinopathy of prematurity in a transitional economy. DESIGN: Retrospective, observational, cohort study. SETTING: National Hospital of Paediatrics, Hanoi, Vietnam. STUDY POPULATION: Premature infants in the Neonatal ward requiring laser treatment for threshold retinopathy of prematurity. MAIN OUTCOME MEASURES: Chronological age and postmenstrual age at treatment. RESULTS: From January 2002 to November 2004, 42 infants from the National Hospital of Paediatrics required laser surgery for threshold retinopathy of prematurity. The mean +/- standard deviation (SD) of birth weight was 1369 +/- 184 g (range 1000-1700); the mean +/- SD of gestation at birth was 30 +/- 1.8 weeks (range 27-34); and the mean +/- SD of postmenstrual age at which treatment occurred in these infants was 36.2 +/- 2.5 weeks (range 31.4-42). A further 58 infants were transferred from other hospitals for laser surgery between January 2004 and October 2004. The mean +/- SD of birth weight was 1325.5 +/- 237.2 g (range 800-1900); the mean +/- SD of gestation at birth was 30 +/- 1.7 weeks (range 28-35); and the mean +/- SD of postmenstrual age at which treatment was given in these infants was 36.3 +/- 2.3 weeks (range 32.71-44.3). DISCUSSIONS: Despite the relative maturity of the gestation of these infants compared with infants in developed countries who develop severe retinopathy of prematurity, the timing of treatment for threshold disease appears to be related to postmenstrual age.
Assuntos
Países em Desenvolvimento/economia , Idade Gestacional , Retinopatia da Prematuridade/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Terapia a Laser/métodos , Masculino , Menopausa , Procedimentos Cirúrgicos Oftalmológicos/métodos , Gravidez , Retinopatia da Prematuridade/cirurgia , Estudos Retrospectivos , Fatores Socioeconômicos , Fatores de Tempo , Vietnã/epidemiologiaRESUMO
We report the case of severe retinopathy of prematurity (ROP) in the donor twin with twin anemia-polycythemia sequence managed with the novel treatment of intrauterine blood transfusions. The fellow polycythemic twin was managed with intrauterine venesection and developed only mild ROP. Thus, despite intrauterine improvement of the twins' hemodynamic conditions, the risk of developing severe ROP remained in the donor twin.