Prevalence and Risk Factors of Retinopathy of Prematurity in Premature Neonates at Pumwani Maternity Hospital

Abstract

Background: Retinopathy of prematurity (ROP) occurs in the retina of preterm infants. It is characterized by incomplete retinal vascularization. ROP is a leading cause of blindness in children. With improved survival rates of extreme preterm newborns, more cases of ROP are now being detected. The development of ROP is linked to several factors that influence the development of vessels in the retina such as use of supplemental oxygen and the duration of the same, neonatal sepsis, jaundice, blood transfusions and nutritional factors among others. Over the last three decades, the third wave of ROP has taken hold, primarily in countries with robust NICU care. An estimated 32000 premature babies became visually impaired from ROP with the highest number in southern East Asia and the Pacific region. Study Objective: To establish the prevalence of ROP in premature babies aged less than or equal to 32 weeks, or weighing less than or equal to 1500 gms, and determine neonatal risk factors associated with ROP occurrence in a Kenyan neonatal unit. Methods: A hospital-based retrospective review of the records of premature infants screened for ROP. Records of all premature infants screened for ROP in the neonatal unit were extracted. Information on Birth weights, Gestational age and neonatal risk factors (neonatal sepsis, respiratory distress syndrome, jaundice and interventions including oxygen administration and blood transfusion) were recorded in a questionnaire and analyzed. Results: A total of 96 babies were enrolled into the study. Of these, 54% were male. The mean gestation weight and age among these babies was 33 weeks and 1712 grams respectively. The median age at enrolment was 32 days. Thirty-three (34.4%) babies had a prescription of oxygen and 4(4.6%) had a blood transfusion prescribed. Respiratory distress and respiratory distress syndrome were the most common respiratory conditions. In this study the prevalence of ROP was 28.9%. The largest proportion (72%) were noted to have stage 1 ROP. There was a male