The Incidence and Risk Factors of Retinopathy of Prematurity in Sick Newborn Care Unit in a Tertiary Care Hospital in Eastern India - A Cross-Sectional Observational Study

BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and mortality throughout the world. Prematurity, low–birth, and oxygen therapy are considered to be the common risk factors. The maldeveloped retina in those affected are very much prone to develop refractive error, neo-vasculopathy, and neurosensory detachment. The purpose of our study was to find out the incidence and ascertain the risk factors of retinopathy of prematurity among the neonates attending the sick neonatal care unit and OPD of Calcutta National Medical College & Hospital. METHODS This is an institution based cross-sectional observational study conducted in the sick newborn care unit of a tertiary care hospital. Informed consent was obtained from the parents along with proper birth history. Indirect ophthalmoscopy with a + 20 dioptre (+ 20 D) lens with a paediatric scleral depressor was performed in each eye under the guidance of the neonatologist after pupillary dilatation. If either eye was found to have ROP, the baby was considered as an ROP case in the study and each eye was considered as a single case. RESULTS 50.27 % babies (N = 91) were delivered by Lower Uterine Segment Caesarean Section (LSCS) and 55. 24 % babies were < 32 weeks of gestational age whereas 21.45 % (N = 39) babies were having < 1500 gm birth weight. Phototherapy was needed in 50 % of the babies (N = 92) whereas hyperbilirubinemia was present in 59.66 % of total babies. Bradycardia, apnoea, and sepsis were present in 29.83 % (N = 54), 25.41 % (N = 46), 41.98 % (N = 76) of the babies respectively. When compared in the two independent groups (ROP present and absent), low gestational age and low birth weight of the babies were found to be statistically significant (P < 0.05) for the development of ROP. After adjusting with different factors in the regression model we have found that low birth weight and oxygen therapy after birth were statistically significant with the development of ROP (P < 0.05). CONCLUSIONS ROP screening, specifically for those babies with low-birthweight, low gestational age, and those who received oxygen therapy for other systemic reasons, is mandatory to have an early diagnosis and treatment done. KEYWORDS ROP, Low-Birthweight, Gestational Age, Oxygen Therapy

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Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.213 ◽

2008 ◽

Vol 47 (169) ◽

Author(s):

Srijana Adhikari ◽

B P Badhu ◽

N K Bhatta ◽

R S Rajbhandari ◽

B K Kalakheti

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Screening Criteria

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

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TO STUDY THE INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

10.36106/gjra/4907071 ◽

2021 ◽

pp. 48-50

Author(s):

Kajaldeep Kaur ◽

Gursharn Singh

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Preterm Neonates ◽

Care Hospital ◽

Northern India ◽

Retinal Examination

BACKGROUND: Retinopathy of prematurity (ROP) is a multifactorial retinal vaso-proliferative disorder which remains a leading cause of childhood blindness worldwide despite improvements in neonatal care and management guidelines. This study was conducted to determine the incidence of ROP among preterm neonates and to determine the risk factors. METHODS: All preterm infants with birth weight <1750 gm and gestation <34 weeks were screened for ROP at 4 weeks of birth for rst screening. Prenatal and postnatal risk factors, neonatal problems, treatment given, procedures and interventions done during stay in neonatal intensive care unit were recorded as per the proforma. The data from the study was systematically collected, compiled and statistically analyzed with SPSS Statistics-26 version to draw relevant conclusions. RESULTS: The incidence of ROP in 89 infants who were screened was 44%. The mean gestational age of babies with ROP was 32 weeks. In our study, pneumonia, apnea, sepsis, thrombocytopenia, NEC, shock, acidosis, IVH, BPD, the use of Bubble CPAP, Venti-CPAP and mechanical ventilator, the vasopressor use and blood transfusion were signicant risk factors. CONCLUSIONS: The incidence of ROP was signicantly higher in babies <34 weeks. It was observed in our that lower the birth weight and lower the gestational age, higher is the risk for the development of ROP. Careful and timed retinal examination of all at risk infants will minimize the development of ROP and later on blindness.

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A retrospective study on the risk factors for retinopathy of prematurity in NICU of tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20182544 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1447

Author(s):

Sundar K. C. ◽

Devi Meenakshi K. ◽

Aruna B. Patil

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Tertiary Care ◽

Care Hospital ◽

College Hospital ◽

Medical College ◽

The Mean

Background: Retinopathy of prematurity (ROP) affects developing retinal vasculature in premature infants. The risk factors for ROP are prematurity, low birth weight, oxygenation, respiratory distress, infection and frequent blood transfusion. Identification of risk factors leading to ROP may help in planning preventive strategies.Methods: A retrospective analysis of records of preterm babies less than 34 weeks of gestation or birth weight less than 1750 grams and between 34 -36 weeks gestation or 1750-2000 grams birth weight associated with risk factors for ROP admitted to NICU of Kilpauk Medical college hospital from August 2015 to July 2016 were evaluated.Results: Out of a total of 166 babies who were screened for ROP, 37 babies were detected to have ROP (22.3 %). Of these 20 (54%) were female and 17 (46%) were male. The mean birth weight of babies with ROP identified in our study was 1480 grams. The mean gestational age of babies with ROP was 32 weeks. By logistic regression analysis for mode of oxygen therapy as a risk factor for ROP it was found that prongs alone showed the strong risk factor towards ROP which was statistically significant. Sepsis, transfusion and shock requiring inotropes individually and statistical significantly contributed to the risk of ROP.Conclusions: ROP was more common in babies <34 weeks. Sepsis, transfusion and shock requiring inotropes significantly contributed to the risk of ROP. Analysis of the mode of oxygen therapy showed that use of prongs significantly increased the risk of ROP.

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A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180529 ◽

2018 ◽

Vol 5 (2) ◽

pp. 427 ◽

Cited By ~ 1

Author(s):

Anuradha D. ◽

Rajesh Kumar S. ◽

Aravind M. A. ◽

Jayakumar M. ◽

J. Ganesh J.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Low Birthweight ◽

Tertiary Care ◽

Birth Asphyxia ◽

Newborn Care ◽

Care Hospital ◽

Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

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Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3105 ◽

2017 ◽

Vol 56 (207) ◽

pp. 325-330

Author(s):

Santosh Pathak ◽

Nagendra Chaudhary ◽

Prativa Dhakal ◽

Shyam Kumar Mahato ◽

Sandeep Shrestha ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Economic Status ◽

Tertiary Care ◽

Growth Curves ◽

Tertiary Hospital ◽

Care Hospital ◽

Cross Sectional ◽

Intrauterine Growth ◽

Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods: This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

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Retinopathy of Prematurity in Neonates and its Risk Factors: A Seven Year Study in Northern Iran

The Open Ophthalmology Journal ◽

10.2174/1874364101610010017 ◽

2016 ◽

Vol 10 (1) ◽

pp. 17-21 ◽

Cited By ~ 4

Author(s):

Seyed Ahmad Rasoulinejad ◽

Mohammad Montazeri

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Multiple Gestation ◽

Northern Iran ◽

Cross Sectional ◽

Ophthalmologic Examination ◽

High Index Of Suspicion

Purpose: An important cause of avoidable childhood blindness is retinopathy of prematurity (ROP) in countries with high human development index and also in some emerging economies countries. To date, no research have been conducted on analyzing data of ROP prevalence in Babol, and this is the first research performed on ROP in this area. Methods: All VLBW babies who referred to Babol ophthalmology center over the seven years, from February 2007 to December 2013 were enrolled in this descriptive cross-sectional research. A team of researchers recorded patients’ information completely in check lists. A single experienced ophthalmologist performed ophthalmologic examination of patients. Result: The incidence of ROP of any stage in Babol was determined to be 306 (45%) of all babies enrolled in this study. In present study, key risk factors of ROP were low gestational age, oxygen therapy more than five days and low birth weight. Conclusion: The findings of current study demonstrate that the main risk factors of developing ROP in newborns are multiple gestation, low birth weight, oxygen therapy for more than five day. Therefore, the progression of ROP to blindness will be prevented by a high index of suspicion, suitable screening, prompt diagnosis, and early treatment.

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Anemia in relation to severity of retinopathy of prematurity in preterm babies born in tertiary care centre in South India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204043 ◽

2020 ◽

Vol 7 (10) ◽

pp. 2005

Author(s):

Hrishikesh S. Pai ◽

Rojo Joy ◽

Varghese Cherian ◽

Preethy Peter

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Tertiary Care ◽

Oxygen Requirement ◽

Tertiary Care Centre ◽

Potential Risk Factors ◽

Preterm Babies

Background: Retinopathy of prematurity (ROP) is a vaso proliferative disorder of retina among preterm infants. Significant cause of blindness in children with increased survival of premature infants with improved neonatal care. Potential risk factors for development of ROP include low gestational age, low birth weight, bronchopulmonary dysplasia, sepsis, acidosis, oxygen therapy. Anemia as a cause for retinopathy of prematurity has been postulated but there are very few studies addressed the effect of anemia on incidence and severity of ROP. The objective of this study was to determine the effect of anemia on incidence and severity of retinopathy of prematurity and to determine other factors associated with development of retinopathy of prematurity.Methods: Retrospective descriptive study of 120 babies born premature less than 34 weeks for the development of Retinopathy of prematurity and its severity and for associated conditions. All babies screened for retinopathy of prematurity at 3 weeks of age and further followed up for progression of ROP. Factors analysed included hemoglobin levels at 3 weeks of life, number of blood transfusions, days on ventilator, gestational age, birth weight, duration of oxygen requirement, bronchopulmonary dysplasia for the development of retinopathy of prematurity. Findings described in simple descriptive manner.Results: Anemia and increased requirement for blood transfusion are associated with higher incidence and severity of ROP. Low gestational age, birth weight, prolonged oxygen requirement, intraventricular hemorrhage (IVH), sepsis are other risk factors.Conclusions: It is significant to screen preterm babies for ROP and to anticipate in the background of these risk factors. Minimise oxygen duration and blood loss for sampling to prevent anemia and reduce transfusions.

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Prevalence and Risk Factors For Retinopathy of Prematurity Among Infants in Minilk-II Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study, 2020.

10.21203/rs.3.rs-148640/v1 ◽

2021 ◽

Author(s):

Emebet Berhane Woldemariam ◽

Hana Endale Aliyou ◽

Yosef Tsige Redi

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Medical Records ◽

Oxygen Therapy ◽

Maternal Education ◽

Cross Sectional ◽

Childhood Blindness ◽

Zone Ii ◽

The Impact

Abstract Background: Retinopathy of prematurity (ROP) is defined as a vaso-proliferative retinal disorder that leads to childhood blindness; and persists as the main cause of preventable childhood blindness. The impact of ROP in developing countries is heavier as term infants can develop ROP because of inadequate awareness of the disease development and the risk factors. Hence, the aim of the study is assessing the prevalence and risk factors for retinopathy of prematurity in the specific study area.Methodology: An institutional based cross-sectional retrospective study was conducted on 301 samples of the pediatrics out-patient eye clinic medical records, at Minilik II referral hospital, from March to April 2020. Study subjects were selected using systematic random sampling method. Data was collected from medical records of all infants visiting the hospital for eye problems from January 2018 to December 2019, using a structured check list. The collected data was entered and cleaned using Epi data 6.4.2.0 and then exported & analyzed using SPSS version 25. Bivariate and multivariate analysis was computed to distinguish the statistically significant factors. Result: The prevalence of ROP among infants in this study showed 39(13%). Of these, more than half (56.4%) were Zone II + Stage 1, followed by Zone II + stage-2, and Stage-5; 12.8% and 10.2% respectively. Birth weight, oxygen therapy and sepsis were the factors significantly associated with ROP [AOR= 39.28; 95% CI: 3.204- 481.658], [AOR= 5.317; 95% CI:1.009- 28.019] and [AOR=9.805; 95% CI:1.592- 60.388] respectively. Conclusions: the prevalence of ROP in the current study is (13%). Birth weight, oxygen therapy and sepsis were the determinant risk factors for development of ROP. Regular ANC, and maternal education may be important to reduce the risk of low-birth weight, and sepsis that results in long-term oxygen therapy leading to childhood blindness.

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Correlation of neonatal gestational age with foot length and right nipple to umbilicus distance

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202141 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1319

Author(s):

Ajay K. Keshwani ◽

Swati S. Suroshe

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Tertiary Care ◽

Large For Gestational Age ◽

P Value ◽

Care Hospital ◽

Cross Sectional ◽

Systematic Analysis ◽

Neonatal Deaths ◽

Foot Length

Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.

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Burden and risk factors associated with low birth weight among newborns in a tertiary care hospital Karachi, Pakistan

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214250 ◽

2021 ◽

Vol 8 (11) ◽

pp. 5202

Author(s):

Azeem Khan ◽

Vikram Kumar ◽

Erum Choudry ◽

Sana Niaz ◽

Mareena Ahmad ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Disease Burden ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Factors Associated ◽

Developed World ◽

Perinatal Survival

Background: Birth weight is one of the significant determinants of perinatal survival and infant morbidity and illnesses during early childhood. The burden of LBW neonates in the developed world is around 7%, whereas it is more than double at around 16.5% in developing countries.Methods: The retrospective cross-sectional study was conducted at the Indus Hospital and Health Network, Karachi, Pakistan. Data was extracted through the electronic medical record (EMR) with specific coding related to LBW from 1st January 2019 to 31st December 2020.Results: Our study showed LBW disease burden of 7.61% equated to 7% in the developed world while, in contrast with LBW prevalence in the developing countries, 16.5%. Gestational diabetes, pregnancy-induced hypertension, and primigravida are the major risk factors associated with LBW.Conclusions: Our study concludes that antenatal care is one of the major aspects to decrease the incidence of LBW, especially in primigravida. By estimating LBW, we can plan early detection and prompt interventions against this problem, reducing the burden of morbidity and mortality in neonates.

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