Affiliations: [a] Neonatology Working Group, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
| [b] Department of Epidemiology, University of Indonesia School of Public Health, Depok, Indonesia
| [c] Department of Pediatrics, Dr. Kariadi Hospital, Diponegoro University, Semarang, Indonesia
| [d] Department of Ophthalmology, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| [e] Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, the Netherlands
Correspondence:
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Address for correspondence: J.E. Siswanto, Neonatology Working Group, Harapan Kita Women and Children Hospital, Jalan Letjen S. Parman Kav 87, Slipi, West Jakarta, Indonesia. Tel.: +62 21 566 8284 ext. 2251; E-mail: [email protected].
Abstract: BACKGROUND:Risk factors other than supplemental oxygen might play a role in the development of retinopathy of prematurity (ROP). In Indonesia ROP occurs in infants up to 34 weeks and 2000 g. Risk factors for the development of ROP in Indonesian NICUs have not been evaluated. Our aim was to identify other risk factors than the use of oxygen in the development and progression of ROP in preterm infants in Indonesia. METHODOLOGY:Data on 98 preterm infants with ROP and 77 controls were collected from four NICUs and two eye centers in Jakarta, Indonesia, between 2009 and 2014. We used multivariate logistic regression analysis to determine the relationship between infants and environmental variables and the development and progression of ROP. We obtained variables for ROP severity by using Cox regression analysis. RESULTS:Factors associated with the development of ROP were birthweight (BWt), intrauterine growth retardation (IUGR), exchange transfusion, duration of oxygen supplementation, minimum saturation monitor setting, and socioeconomic factors. Regarding the progression, gestational age (GA), out-born, duration of supplemental oxygen, minimum saturation monitor setting, and socioeconomic factors were identified as risk factors. CONCLUSION:The use and control of supplemental oxygen are the main risk factors for the development and progression of ROP in preterms in Indonesia. Additionally, we confirm that GA, BWt, and IUGR are risk factors. Moreover, we found exchange transfusion to be a risk factor, and we found a lower rate of ROP in infants from a lower socioeconomic background. These risk factors apply to infants with a GA up to 34 weeks and a BWt up to 2000 g.
Keywords: retinopathy of prematurity ROP, neonatal risk factors, oxygen
supplementation
