title: Analysis of incidence and risk factors of retinopathy of prematurity among very-low-birth-weight infants in North Taiwan.
abstract: BACKGROUND
  Although significant advances have been made in perinatal care, retinopathy of prematurity (ROP) remains a serious complication in prematurely born individuals. There have been limited studies on ROP in Taiwan, and most of those existing reports are outdated.
  
  
  METHODS
  This retrospective study included 252 very-low-birth-weight (VLBW) infants admitted to the neonatal intensive care unit of Chang Gung Children's Hospital over a 2-year period between July 2005 and June 2007. All infants were examined for ROP according to the guidelines published by the American Academy of Pediatrics. The relationship between clinical risk factors and the development of ROP was analyzed.
  
  
  RESULTS
  Of the 252 VLBW infants, 216 met the screening criteria. Of the 216, 99 (45.8%) had ROP. Compared with neonates born at 29 weeks of gestational age (GA) or later, those very premature infants of ≤25 weeks' and 26-28 weeks' GA had increased odds ratios (OR) of 8.49 and 3.19, respectively, for the development of severe ROP. No ROP was detected in infants of greater than 33 weeks' GA. The simultaneous presence of a low GA, low birth weight (LBW), lower Apgar scores, hypotension, patent ductus arteriosus, septicemia, intraventricular hemorrhage, ventilator dependence, and use of postnatal steroids was associated with severe ROP. Using multiple logistic regression analyses for ROP, only maternal preeclampsia [OR, 2.52; confidence interval (CI), 1.32-4.7]; duration of mechanical ventilation (OR, 1.06; CI, 1.04-1.08); and LBW (OR, 2.62; CI, 1.370-3.375) predicted the development of threshold ROP.
  
  
  CONCLUSIONS
  The incidence of ROP among VLBW infants was 45.8%; 19.0% had severe ROP. Infants of lower GAs and/or with LBW, whose mother had preeclampsia or who had a long duration of mechanical ventilation are at risk for the development of threshold ROP.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chang-Yo
authors.initials: CY
authors.lastname: Yang
authors.forename: Reyin
authors.initials: R
authors.lastname: Lien
authors.forename: Peng-Hong
authors.initials: PH
authors.lastname: Yang
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Chu
authors.forename: Jen-Fu
authors.initials: JF
authors.lastname: Hsu
authors.forename: Ren-Huei
authors.initials: RH
authors.lastname: Fu
authors.forename: Ming-Chou
authors.initials: MC
authors.lastname: Chiang
mesh_terms: D001034:Apgar Score; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D011247:Pregnancy; D012178:Retinopathy of Prematurity / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology