Retinopathy of Prematurity Among Very Low-Birth-Weight Infants in China: Incidence and Perinatal Risk Factors

PURPOSE. Retinopathy of prematurity (ROP) is the leading cause of blindness in children worldwide. This study aimed to determine the incidence and perinatal risk factors for ROP in very low-birth-weight (VLBW) Chinese infants. METHODS. A retrospective study of the medical records of 504 VLBW infants screened for ROP from 2012 to 2015 was performed in West China Second University Hospital. VLBW infants were examined according to the Royal College of Ophthalmologists ROP guideline and retinopathy was graded following the International Classification of ROP. Perinatal risk factors for ROP were assessed using univariate and multivariate analyses. RESULTS. The overall incidence of ROP in our study was 26.0% (131/504). Stage 1 ROP, stage 2 ROP, and stage >= 3 ROP were detected in 17.5%, 5.4%, and 3.2% of the infants screened, respectively. In the univariate analysis, many perinatal risk factors were found to have a significant association with ROP. In the subsequent multivariate analysis, in vitro fertilization (IVF) (odds ratio [OR] = 1.896; 95% confidence interval [CI] 1.031-3.486), gestational age (GA) < 32 weeks (OR = 2.171; 95% CI 1.085-4.346), apnea (OR = 2.001; 95% CI 1.224-3.272), bronchopulmonary dysplasia (BPD) (OR = 5.098; 95% CI 2.307-11.265), sepsis (OR = 2.212; 95% CI 1.070-4.576), patent ductus arteriosus (PDA) (OR = 1.675; 95% CI 1.011-2.774), and blood transfusion (OR = 1.819; 95% CI 1.046-3.163) were independently associated with the development of ROP (all P < 0.05). CONCLUSIONS. In VLBW Chinese infants, IVF, GA < 32 weeks, apnea, BPD, sepsis, PDA, and blood transfusion were independent perinatal risk factors for ROP.