Factors associated with failure to screen newborns for retinopathy of prematurity.
OBJECTIVE
To evaluate ROP screening rates in a population-based cohort; and to identify characteristics of patients that were missed.


METHODS
We used the California Perinatal Quality Care Collaborative data from 2005-2007 for a cross-sectional study. Using eligibility criteria, screening rates were calculated for each hospital. Multivariable regression was used to assess associations between patient clinical and sociodemographic factors and the odds of missing screening.


RESULTS
Overall rates of missed ROP screening decreased from 18.6% in 2005 to 12.8% in 2007. Higher gestational age (OR = 1.25 for increase of 1 week, 95% CI, 1.21-1.29), higher birth weight (OR = 1.13; 95% CI, 1.10-1.15), and singleton birth (OR = 1.2; 95% CI, 1.07-1.34) were associated with higher probability of missing screening. Level II neonatal intensive care units and neonatal intensive care units with lower volume were more likely to miss screenings.


CONCLUSIONS
Although ROP screening rates improved over time, larger and older infants are at risk for not receiving screening. Furthermore, large variations in screening rates exist among hospitals in California. Identification of gaps in quality of care creates an opportunity to improve ROP screening rates and prevent impaired vision in this vulnerable population.
University of California, San Francisco, CA 94143, USA. bainl@peds.ucsf.edu
Lisa Charo
LC
Bain
R Adams
RA
Dudley
Jeffrey B
JB
Gould
Henry C
HC
Lee
D001724:Birth Weight; D002140:California; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D008297:Male; D015999:Multivariate Analysis; D015997:Neonatal Screening / Q000379:methods*; D012044:Regression Analysis; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D012306:Risk; D014786:Vision Disorders / Q000517:prevention & control