出生后体重增加率对早产儿重度视网膜病变的预测价值:回顾性分析。

IF 2.4 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Multidisciplinary Healthcare Pub Date : 2025-08-30 eCollection Date: 2025-01-01 DOI:10.2147/JMDH.S528155
Jiangya Wang, Qingmin Ma, Fangfang Du
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引用次数: 0

摘要

背景:随着新生儿重症监护的改善,早产儿视网膜病变(ROP)在中国呈上升趋势。目前的筛查依赖于胎龄(GA)和出生体重(BW),面临着资源限制和婴儿负担的挑战。出生后体重增加率(WGR)是一个潜在的预测指标,但其价值的可靠数据,特别是对严重ROP的价值,以及在中国人群中验证的阈值缺乏。本研究旨在探讨与ROP视网膜病变发生率相关的危险因素。方法:对2016-2020年新生儿重症监护病房收治的230例早产儿(GA≤32周,BW≤2000g)进行回顾性队列分析。将婴儿分为非ROP组(n=189)和ROP组(n=41);ROP组进一步分为轻度(n=32)和重度(n=9)亚组。分析临床资料,包括GA、BW、合并症和WGR。采用单因素分析、多因素logistic回归及受试者工作特征(ROC)曲线分析。结果:在单因素分析中,非ROP组的GA、BW和增重率均优于ROP组(均P < 0.05)。多因素分析发现,较低的GA (OR=0.91, 95% CI=0.83-0.99, P=0.03)、较低的体重(OR=0.99, 95% CI=0.99-1.00, P=0.04)和较低的WGR (OR=0.73, 95% CI=0.63-0.83, P)与较高的ROP易感性相关。值得注意的是,体重增加率的降低可以作为严重ROP的预期标志,因为它更容易导致严重ROP的发生。试验注册:注册中心全称:中国临床试验注册中心,http://www.chictr.org.cn。试验注册号:chiCTR2400087938。注册日期:2024-08-07。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Predictive Value of Postnatal Weight Gain Rate for Severe Retinopathy of Prematurity in Preterm Infants: A Retrospective Analysis.

Predictive Value of Postnatal Weight Gain Rate for Severe Retinopathy of Prematurity in Preterm Infants: A Retrospective Analysis.

Predictive Value of Postnatal Weight Gain Rate for Severe Retinopathy of Prematurity in Preterm Infants: A Retrospective Analysis.

Background: Retinopathy of prematurity (ROP) is rising in China alongside improved neonatal intensive care. Current screening, reliant on gestational age (GA) and birth weight (BW), faces challenges of resource constraints and infant burden. Postnatal weight gain rate (WGR) is a potential predictive marker, but robust data on its value, particularly for severe ROP, and validated thresholds within the Chinese population are lacking. The study aimed to examine the risk factors linked with the incidence of retinopathy of ROP.

Methods: A retrospective cohort analysis was conducted on 230 preterm infants (GA ≤32 weeks, BW ≤2000g) admitted to a neonatal intensive care unit (2016-2020). Infants were categorized into non-ROP (n=189) and ROP (n=41) groups; the ROP group was further stratified into mild (n=32) and severe (n=9) subgroups. Clinical data, including GA, BW, comorbidities and WGR, were analyzed. Univariate analysis, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were employed.

Results: In the univariate analysis, the non-ROP group manifested superior values in GA, BW, and rates of weight gain in comparison to the ROP group (all P < 0.05). Multivariate analysis identified lower GA (OR=0.91, 95% CI=0.83-0.99, P=0.03), lower BW (OR=0.99, 95% CI=0.99-1.00, P=0.04), and lower WGR (OR=0.73, 95% CI=0.63-0.83, P<0.01) as independent risk factors for ROP. GA, BW, and WGR were significantly higher in the mild vs severe ROP group (all P<0.05). ROC analysis demonstrated that WGR <24.5 g/day predicted any ROP (AUC=0.939, 95% CI=0.905-0.973, sensitivity 90.2%, specificity 86.8%, P<0.05). Crucially, WGR <18 g/day predicted severe ROP (AUC=0.865, 95% CI=0.70-1.00, sensitivity 100%, specificity 66,7%, P<0.05).

Conclusion: Diminished GA, reduced BW, and sluggish weight gain rates have been correlated with an elevated susceptibility to ROP. Notably, a diminished rate of weight gain can serve as an anticipatory marker for severe ROP, given its heightened propensity to precipitate the onset of severe ROP.

Trial registration: Full name of the registry: Chinese Clinical Trial Registry, http://www.chictr.org.cn. Trial registration number: chiCTR2400087938. Date of registration: 2024-08-07.

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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
期刊介绍: The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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