title: [Retinopathy of prematurity in multiple births: risk analysis for plus disease].
abstract: OBJECTIVE
  To analyze the risk factors associated with plus disease in retinopathy of prematurity (ROP).
  
  
  METHODS
  Over a period of 8.5 years we carried out a prospective study of ROP in twins and triplets. Fifty-four multiple-birth infants with low birth weight (< or =1500 g) and low gestational age (32< or = weeks) were admitted to the University Hospital of Granada.
  
  
  RESULTS
  Logistic regression analyses showed the following variables to be associated with an increased risk of plus disease: severe ROP, large area of avascular retina, low gestational age, low birth weight, a patent ductus arteriosus, length of mechanical ventilation, adverse events increase, low 5 min Apgar scores and poor postnatal weight gain (in the first 4 to 6 weeks of life). Using multiple logistic regression, only the grade of ROP (OR: 5.5; p < 0.009) and poor postnatal weight gain (OR: 0.58; p < 0.04) were predictive factors of development of plus disease. Infants with <<plus>> disease gained an average 3.9 +/- 3.1 g/day in the first 6 weeks of life, compared to a mean of 11.84 +/- 8.3 g/day for those without plus disease (p < 0.0001).
  
  
  CONCLUSIONS
  Advanced ROP stages and poor weight gain were the most significant factors associated with plus disease. Twins who gained weight at more than 7 g/day in the first 4-6 weeks of life had a significantly reduced risk of plus disease. A good weight gain is an effective strategy against avoidable blindness due to ROP.
authors.affiliation: Servicio de Oftalmología, Unidad de Gestión Clínica, Hospital Universitario San Cecilio de Granada, Granada, España. jopalace@hotmail.com
authors.forename: J L
authors.initials: JL
authors.lastname: García-Serrano
authors.forename: M C
authors.initials: MC
authors.lastname: Ramírez-García
authors.forename: R
authors.initials: R
authors.lastname: Piñar-Molina
mesh_terms: D001034:Apgar Score; D018450:Disease Progression; D004200:Diseases in Twins / Q000453:epidemiology*; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012121:Respiration, Artificial; D012171:Retinal Vessels / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000453:epidemiology* / Q000473:pathology; D018570:Risk Assessment; D014310:Triplets; D015430:Weight Gain