Barriers to screening infants for retinopathy of prematurity after discharge or transfer from a neonatal intensive care unit.
OBJECTIVE
To assess neonatal intensive care unit (NICU) practices affecting screening and follow-up for retinopathy of prematurity (ROP).


METHODS
Retrospective study of infants at risk for ROP, eligible for back transport, admitted to a regional NICU from January 1, 1999 until May 31, 2002. Patients failed to receive needed follow-up for ROP after discharge or transfer from a NICU, if we could not verify their ROP screening follow-up within 1 month.


RESULTS
A total of 74 infants were identified to need follow-up eye care. Infants who did not receive the follow-up care had greater mean gestational age (mean SD; 30.7+/-2.3 vs 29.6+/-2.5 weeks, p=0.05) and birth weights (mean SD; 1581+/-366 vs 1360+/-508 g, p=0.007), compared to infants who received the recommended care. Infants transported back to the community hospital were significantly more likely to miss follow-up eye care compared to infants discharged from the regional center (relative risk 2.81, 95% confidence interval (CI) (1.09 to 7.20)). Infants not screened for ROP in the NICU had greater risk for missing follow-up care compared to infants who had their first retinal examination in the NICU (relative risk 4.25, 95% CI (1.42 to 12.73)).


CONCLUSIONS
Infants transferred back or discharged from the NICU before ROP screening represent a high-risk group for not receiving follow-up eye care.
Attar
Mohammad A
MA
Department of Pediatrics and Communicable Diseases, University of Michigan, MI 48109, USA.
Gates
Molly R
MR
Iatrow
Ann M
AM
Lang
Sylvia W
SW
Bratton
Susan L
SL
D015331:Cohort Studies; D006764:Hospitals, Community; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D015997:Neonatal Screening / Q000379:methods*; D009725:Nurseries, Hospital; D010349:Patient Compliance; D010351:Patient Discharge; D010360:Patient Transfer; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D012189:Retrospective Studies