Correlation between Postnatal Weight Gain and Development of Retinopathy of Prematurity: An Experience in Rural Tertiary Care Centre
Dr. MN Asha,
#468, 4th Main Nagendra Block, 50 ft Road, Hanumanthnagar, Bengaluru-560050, Karnataka, India.
Introduction: Retinopathy Of Prematurity (ROP) is one of the leading causes of preventable blindness in our country. The minor risk factors responsible for development of such at Neonatal Intensive Care Unit (NICU) is still under discovery. It needs multiple trials to conclude or have guidelines on when to screen an infant. In order to make an attempt to fill the above knowledge gap, this study was conducted at our rural tertiary centre.
Aim: To determine the need for early screening for ROP before discharge. Also, to study the relation between postnatal weight gain and risk of developing ROP and to determine the usefulness of CHOP-ROP (Childrenâ€™s Hospital of Philadelphia-ROP) model in Indian population in order to use it as a predictor model for ROP screening purpose.
Materials and Methods: This was a retrospective two year study of infants admitted in NICU between June 2016-May 2018 at Adichunchanagiri Institute of Medical Sciences, a rural tertiary care centre. ROP screening was carried out as per National guidelines and objective of the study. A cohort of 75, was eligible for the study; in these infants ROP screening was done before discharge, looked for postnatal weight gain and its relation to development of ROP. Also the CHOP â€“ ROP algorithm was used to classify those who needed and not needed the early screening.
Results: Of 75 infants studied all infants were screened for ROP before discharge, out of which 60 (80%) were not found to have ROP and 15 (20%) were found to have ROP, no screened out infant developed ROP successively. Among the 15 (20%) infants who developed ROP, 11 (73.3%) infants were having an average weight gain less than 10 gm/day and we found a positive correlation with development of ROP (p=0.101), Fischer-Exact test. By using CHOP-ROP algorithm it was found that, two infants were classified eligible for screening out of 75 infants and both infants had ROP; remaining 73 (97.3%) were classified as not eligible for screening and 13 (86.7%) of these developed ROP (p=0.003, Fischer-Exact test).
Conclusion: Early screening of infants for ROP has been as effective as the national guidelines and in fact has helped in early identification of cases. Also, we found that poor postnatal weight gain has significant correlation with development of ROP. CHOP-ROP model although is statistically significant but has failed to classify large number of cases as risk group for ROP.