Prematüre Retinopatisi Sıklığı ve Risk Faktörlerinin Değerlendirilmesi

Year 2019, , 63 - 68, 14.03.2019

Selim Sancak , Sevilay Topçuoğlu , Gökhan Çelik , Murat Günay , Güner Karatekin

https://doi.org/10.16948/zktipb.474762

Abstract

Amaç:
Prematüre retinopatisi (PR) sıklığı ve risk faktörlerinin belirlenmesi

Gereç ve Yöntemler:
Dört yıllık sürede (1 Ocak 2011 - 27 Aralık 2014) yenidoğan yoğun bakım
ünitemizde takip edilen, gebelik yaşı ≤ 32 hafta veya doğum ağırlığı ≤ 1500 g
888 preterm yenidoğanın PR tarama sonuçları geriye dönük olarak
değerlendirildi. Tedavi alan ve almayan pretermlerin verileri Student T ve Ki
kare testleri ile karşılaştırıldı. PR tedavisi için anlamlı bulunan değişkenler
bağımsız risk faktörleri açısından lojistik regresyon analizi ile
değerlendirildi.

Bulgular:
PR saptanan 386 hastanın ortalama gebelik yaşı 28.6 ± 1.9 hafta ve doğum kilosu
1085 ± 287 g, PR olmayan 502 hastanın ise 30.3 ± 1.7 hafta ve 1413 ± 298 g
bulundu. PR oranı % 43 saptandı. PR olan hastalar, tedavi alanlar ve almayanlar
şeklinde incelendiklerinde; tedavi alan 114 (% 29.5) hastanın ortalama gebelik
yaşı 27.43 ± 2.03 hafta ve doğum kilosu 969 ± 276 g, tedavi almayan 272 (%
70.5) hastanın ise 29.07 ± 1.73 hafta ve 1134 ± 278 g bulundu. Tekli oran
karşılaştırılmalarında gebelik yaşı, doğum ağırlığı, erkek cinsiyet, antenatal
steroid yokluğu, koryoamniyonit, respiratuar distres sendromu, inotrop kullanımı,
eritrosit transfüzyonu, sepsis, patent duktus arteriosus,
intraventriküler kanama ve toplam oksijen verilme süreleri farklı bulundu.
Lojistik regresyon analizinde ise gebelik yaşı [Relative risk (RR): 0.74, % 95
Confidence interval (Cİ): 0.63 - 0.87], erkek cinsiyet (RR: 1.9, % 95 Cİ: 1.14
- 3.17) ve eritrosit transfüzyonu (RR: 2.52, % 95 Cİ: 1.3 - 4.9) bağımsız risk
faktörleri olarak tespit edildi.

Sonuç:
Aşırı preterm yenidoğanların sağ kalımlarındaki artış nedeniyle prematüre
retinopatisi sıklığı önemli bir sorun olmaya devam etmektedir. Etkili risk
faktörlerinin azaltılması ile retinopati morbiditesi azaltılabilir.

Keywords

Prematüre retinopatisi, preterm yenidoğan

Evaluation of the Incidence and Risk Factors of Retinopathy of Prematurity

Abstract

Aim: To evaluate the incidence and risk factors of retinopathy of prematurity (ROP)

Materials and Methods: Results of ROP screening of the four years period (from 1 January 2011 to 27 December 2014) were assessed retrospectively. Data of preterm newborns with and without intervention for ROP were compared with statistics of Student T and Ki square tests. Variables that are found significant for ROP with intervention were examined with logistic regression analysis in term of independent risk factors.

Results: ROP was detected in 386 preterms with a mean gestational age of 28.6 ± 1.9 weeks and birth weight of 1085 ± 287 and patients without ROP with a mean gestational age of 30.3 ± 1.7 weeks and birth weight of 1413 ± 298, respectively. The overall incidence of ROP was 43.4 %. Patients with ROP were grouped into with and without intervention; 114 preterms with intervention (29.5 %) had a mean gestational age of  27.43 ± 2.03 weeks and birth weight 969 ± 276 g and 272 preterms without intervention (70.5 %) had a mean gestational age of  29.07 ± 1.73 weeks and birth weight 1134 ± 278 g. Male gender, the absence of antenatal steroid, chorioamnionitis, respiratory distress syndrome, inotrope use, erythrocyte transfusion, sepsis, patent ductus arteriosus, intraventricular hemorrhage, and total oxygen use were found significantly higher in the preterms with intervention than the preterms without intervention. On the contrary, gestational age and birthweight birth weight were found significantly lower in the preterms with intervention. Gestational age, male gender, and erythrocyte transfusion were identified as independent risk factors.

Discussion and Conclusion: ROP remains a crucial issue in excessively preterm newborns that have increased survival rates. Reduction of risk factors may decrease morbidity of ROP.

Keywords

Retinpathy of prematurity, preterm newborn

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