Retinopatiada prematuridade: incidência, fatores de risco e gravidade

Abstract

Introduction: Retinopathy of prematurity (ROP) is a disease of retinal vascular and capillary proliferation that affects preterm newborns undergoing oxygen therapy and is one of the main causes of visual impairment and childhood blindness worldwide. Several factors interfere in the different pathological stages of the disease and timely screening and treatment are critical for newborns at risk for developing ROP. Objective: To evaluate the incidence, risk factors and severity of retinopathy of prematurity (ROP) in preterm (PTRN) and very low birth weight (VLBW) newborns (NB) in a hospital university. Methods: Retrospective cohort study, developed with data obtained from a database of patients from the Neonatal Intensive Care Unit (NICU) of a university hospital from January 2014 to December 2022. They were eligible all PTRN with gestational age < 32w ou birth weight < 1500g. Maternal and PTNB data were evaluated. Results: During the studied period, 853 newborns were included and, of these, 171 were diagnosed with ROP. The average incidence of ROP between the years studied was 20%. Among preterm infants diagnosed with ROP, the majority had mild retinal involvement (49.1% - grade I), followed by grades II (28.6%) and III (22.6%), respectively. The possible risk factors for the occurrence of ROP, after adjustments for confounding variables, were longer oxygen therapy time (RR 1.016, p<0.001), longer mechanical ventilation time (RR 1.014, p<0.001), use of postnatal corticosteroids for the treatment of bronchopulmonary dysplasia (RR 3.182, p<0.001), the diagnosis of patent ductus arteriosus (RR 1.692, p=0.002) and blood transfusion (RR 1.699, p=0.003). Conclusion: The incidence of ROP was 20% during the studied period, with a predominance of mild cases. The main risk factors were longer time on oxygen therapy, longer time on mechanical ventilation, use of postnatal corticosteroids for bronchopulmonary dysplasia, diagnosis of patent ductus arteriosus and blood transfusion.