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Abstract：
BACKGROUND: This research aimed to identify the clinical profile and risk factors of retinopathy of prematurity (ROP) among \"at-risk\" newborns treated at a sick newborn care unit (SNCU) located at high altitude in North India, with the intention of contributing to formulate regional and national ROP screening guidelines.
METHODS: In a prospective observational study from 2021 to 2022, outborn and inborn babies eligible for ROP screening were screened.
RESULTS: Total 39/122 screened neonates had laser for Type 1 ROP, and 22/39 (56.4%) had aggressive ROP (AROP). The average birth weight (BW) was 1803.87 g, and the average gestational age was 34 weeks. Respiratory distress, bronchopulmonary dysplasia, sepsis, and apnea were present in 57.3%, 13%, 52.5%, and 25.4%, respectively. Sight-threatening ROP was present in 50% below 28+6 weeks, 27% between 29 and 30+6 weeks, 52% between 31 and 33+6 weeks, and 15% with gestation >34 weeks. Two babies with Type 1 ROP weighed >2 kg and one had AROP. Upon regression analysis, BW <1500 g, gestation <32 weeks, oxygen >48 h, clinical sepsis, total SNCU stay >14 days, continuous positive airway pressure support with oxygen >50%, and >10 days to achieve full feeds were associated with severe ROP. Caffeine to treat apnea and kangaroo mother care reduced ROP. None had short-term unfavorable outcome.
CONCLUSIONS: With similar infrastructure and work force shortage in most SNCUs, these findings can be generalized. The burden of Type 1 and AROP is increasing, as seen in higher gestation and BWs. This needs revision of ROP screening criteria at local and national level. It is crucial to emphasize on the importance of pediatrician and ophthalmologist collaboration, early ROP screening, diagnosis, and treatment to stop disease progression to severe ROP.
METHODS: In a prospective observational study from 2021 to 2022, outborn and inborn babies eligible for ROP screening were screened.
RESULTS: Total 39/122 screened neonates had laser for Type 1 ROP, and 22/39 (56.4%) had aggressive ROP (AROP). The average birth weight (BW) was 1803.87 g, and the average gestational age was 34 weeks. Respiratory distress, bronchopulmonary dysplasia, sepsis, and apnea were present in 57.3%, 13%, 52.5%, and 25.4%, respectively. Sight-threatening ROP was present in 50% below 28+6 weeks, 27% between 29 and 30+6 weeks, 52% between 31 and 33+6 weeks, and 15% with gestation >34 weeks. Two babies with Type 1 ROP weighed >2 kg and one had AROP. Upon regression analysis, BW <1500 g, gestation <32 weeks, oxygen >48 h, clinical sepsis, total SNCU stay >14 days, continuous positive airway pressure support with oxygen >50%, and >10 days to achieve full feeds were associated with severe ROP. Caffeine to treat apnea and kangaroo mother care reduced ROP. None had short-term unfavorable outcome.
CONCLUSIONS: With similar infrastructure and work force shortage in most SNCUs, these findings can be generalized. The burden of Type 1 and AROP is increasing, as seen in higher gestation and BWs. This needs revision of ROP screening criteria at local and national level. It is crucial to emphasize on the importance of pediatrician and ophthalmologist collaboration, early ROP screening, diagnosis, and treatment to stop disease progression to severe ROP.
摘要：
背景：这项研究旨在确定在位于印度北部高海拔地区的病态新生儿监护病房（SNCU）接受治疗的“高危”新生儿中早产儿视网膜病变（ROP）的临床特征和危险因素，旨在为制定区域和国家ROP筛查指南做出贡献。
方法：在2021年至2022年的一项前瞻性观察性研究中，筛选了符合ROP筛查条件的新生儿和新生儿。
结果：总共39/122名筛查的新生儿接受了1型ROP激光检查，22/39（56.4%）有侵袭性ROP（AROP）。平均出生体重(BW)为1803.87克,平均胎龄为34周。呼吸窘迫,支气管肺发育不良,脓毒症,呼吸暂停占57.3%，13%,52.5%,和25.4%，分别。在28+6周以下，有50％的人存在威胁视力的ROP，27％在29和30+6周之间，52%在31和33+6周之间，和15％的妊娠>34周。两个1型ROP的婴儿体重>2公斤，一个有AROP。经过回归分析，BW<1500g,妊娠<32周，氧气>48小时，临床脓毒症,SNCU总停留时间>14天，持续气道正压通气支持，氧气>50%，>10天达到全食与严重ROP相关。咖啡因治疗呼吸暂停和袋鼠母亲护理降低ROP。没有人出现短期不利结果。
结论：在大多数SNCU中，类似的基础设施和劳动力短缺，这些发现可以概括。1型和AROP的负担正在增加，如在较高的妊娠和BW中所见。这需要在地方和国家层面修订ROP筛选标准。强调儿科医生和眼科医生合作的重要性至关重要，早期ROP筛查,诊断,和治疗以阻止疾病进展为严重的ROP。
方法：在2021年至2022年的一项前瞻性观察性研究中，筛选了符合ROP筛查条件的新生儿和新生儿。
结果：总共39/122名筛查的新生儿接受了1型ROP激光检查，22/39（56.4%）有侵袭性ROP（AROP）。平均出生体重(BW)为1803.87克,平均胎龄为34周。呼吸窘迫,支气管肺发育不良,脓毒症,呼吸暂停占57.3%，13%,52.5%,和25.4%，分别。在28+6周以下，有50％的人存在威胁视力的ROP，27％在29和30+6周之间，52%在31和33+6周之间，和15％的妊娠>34周。两个1型ROP的婴儿体重>2公斤，一个有AROP。经过回归分析，BW<1500g,妊娠<32周，氧气>48小时，临床脓毒症,SNCU总停留时间>14天，持续气道正压通气支持，氧气>50%，>10天达到全食与严重ROP相关。咖啡因治疗呼吸暂停和袋鼠母亲护理降低ROP。没有人出现短期不利结果。
结论：在大多数SNCU中，类似的基础设施和劳动力短缺，这些发现可以概括。1型和AROP的负担正在增加，如在较高的妊娠和BW中所见。这需要在地方和国家层面修订ROP筛选标准。强调儿科医生和眼科医生合作的重要性至关重要，早期ROP筛查,诊断,和治疗以阻止疾病进展为严重的ROP。
