Predicting proliferative retinopathy in a Brazilian population of preterm infants with the screening algorithm WINROP.
OBJECTIVE
To retrospectively validate the WINROP (weight, insulinlike growth factor I, neonatal, retinopathy of prematurity [ROP]) algorithm in a Brazilian population. WINROP aims to predict ROP and is based on longitudinal weight measurements from birth until postmenstrual age 36 weeks. WINROP has predicted 100% of severe ROP in 3 neonatal intensive care unit settings in the United States and Sweden.


METHODS
In children admitted to the neonatal intensive care unit at Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil, from April 2002 to October 2008, weight measurements had been recorded once a week for children screened for ROP, 366 of whom had a gestational age of 32 weeks or less. The participating children had a median gestational age of 30 weeks (range, 24-32 weeks) at birth and their median birth weight was 1215 g (range, 505-2000 g).


RESULTS
For 192 of 366 children (53%), no alarm or low-risk alarm after postmenstrual age 32 weeks occurred. Of these, 190 of 192 did not develop proliferative disease. Two boys with severe sepsis who were treated for ROP received low-risk alarms at postmenstrual age 33 and 34 weeks, respectively. The remaining 174 children (47%) received high- or low-risk alarms before or at 32 weeks. Of these infants, 21 (12%) developed proliferative ROP.


CONCLUSIONS
In this Brazilian population, WINROP, with limited information on specific gestational age and date of weight measurement, detected early 90.5% of infants who developed stage 3 ROP and correctly predicted the majority who did not. Adjustments to the algorithm for specific neonatal intensive care unit populations may improve the results for specific preterm populations.
Department of Ophthalmology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Anna-Lena
AL
Hård
Chatarina
C
Löfqvist
Joao Borges
JB
Fortes Filho
Renato Soibelmann
RS
Procianoy
Lois
L
Smith
Ann
A
Hellström
D000465:Algorithms; D001724:Birth Weight / Q000502:physiology*; D001938:Brazil; D003906:Developing Countries; D003941:Diagnostic Techniques, Ophthalmological; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D011237:Predictive Value of Tests; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D007334:Insulin-Like Growth Factor I