[Retinopathy of prematurity: 10-year retrospective study at the University Hospital of Strasbourg].
OBJECTIVE
This work was splitted in two parts: the first one was the study of retinopathy incidence in premature infants less than 33 weeks gestation, born between 1988 and 1997; the second one is the identification of severe retinopathy different risk factors.


METHODS
Our study was retrospective over ten years. All premature infants less than 33 weeks gestation born between January 1, 1988 and December 31 1997, admitted to the Strasbourg neonatal intensive care unit with retinopathy, were included (164 children). First we studied the incidence evolution of retinopathy over these ten years; then by a statistical study (univaried and multivaried) we looked for a significant difference for several factors between the infants with mild retinopathy and the group with severe ocular disease.


RESULTS
Retinopathy incidence decreased in ten years from 13.7 to 6.7% for the moderate forms (P < 0.001) and from 3.7 to 1.7% for severe stage (non significant). A significant difference was found for various factors after comparison between both groups. The birth weight (P = 5 x 10(-4)), the gestational age (P = 4 x 10(-6)), were weaker in the group with severe retinopathy. A maternofetal or nosocomial infection (P = 0.009; P = 0.002), hemodynamic shock (P = 10(-6)), patent ductus arteriosus (P = 10(-6)), bronchopulmonary dysplasia (P = 3 x 10(-6)), postnatal steroid treatment (P = 0.007), respiratory distress syndrome (P = 0.01), were all more frequent in the severe retinopathy sample. The number of days with oxygenotherapy (P = 10(-6)) and mechanical ventilation (P = 10(-6)) the number of blood transfusion (P = 10(-5)) were higher in this group than in the other. The logistic regression analysis showed that the hemodynamic parameters influence mostly on the risk of severe ocular disease, like an hemodynamic shock syndrome (OR = 16.94; CI = 2.12-135.77) or a patent ductus arteriosus (OR = 5.36; CI = 1.53-18.74).


CONCLUSIONS
A decrease of the retinopathy incidence in premature infants was observed in ten years, probably due to better care in the neonatal period. An unstable hemodynamic state would be one prominent risk factor in the genesis of severe retinopathy of prematurity.
Gaugler
C
C
Service de pédiatrie II, hôpital de Hautepierre, 67098 Strasbourg, France.
Beladdale
J
J
Astruc
D
D
Schaeffer
D
D
Donato
L
L
Speeg-Schatz
C
C
Siméoni
U
U
Messer
J
J
D001803:Blood Transfusion; D003428:Cross Infection; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D012178:Retinopathy of Prematurity / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000150:complications; D013256:Steroids / Q000009:adverse effects
D013256:Steroids