title: Systemic changes and adverse effects induced by retinopathy of prematurity screening.
abstract: OBJECTIVE
  To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening.
  
  
  METHODS
  A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval.
  
  
  RESULTS
  Totally 1254 prematurity babies receiving ROP screening during Jan. 1(st) 2013 to Dec. 31(th) 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (P<0.01) increase in systolic BP and a 7.24 mm Hg (P<0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm (P<0.01) higher than the 133.3±9.0 bpm control level. The oxygen saturation shared an average drop of 5% (P<0.01) during screening. In prematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01).
  
  
  CONCLUSIONS
  In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.
authors: Department of Neonatology, Guangdong Province Women and Children's Hospital, Guangzhou 511400, Guangdong Province, China; Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors: Jing-Bo
authors: JB
authors: Jiang
authors: Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors: Zhi-Wei
authors: ZW
authors: Zhang
authors: Department of Neonatology, Guangdong Province Women and Children's Hospital, Guangzhou 511400, Guangdong Province, China.
authors: Jia-Wen
authors: JW
authors: Zhang
authors: Department of Neonatology, Guangdong Province Women and Children's Hospital, Guangzhou 511400, Guangdong Province, China.
authors: Yan-Li
authors: YL
authors: Wang
authors: Department of Neonatology, Guangdong Province Women and Children's Hospital, Guangzhou 511400, Guangdong Province, China.
authors: Chuan
authors: C
authors: Nie
authors: Department of Neonatology, Guangdong Province Women and Children's Hospital, Guangzhou 511400, Guangdong Province, China.
authors: Xian-Qiong
authors: XQ
authors: Luo
keywords: apnea; mydriatic drops; necrotizing enterocolitis; prematurity; retinopathy of prematurity; screening; stress response