{"title":"中国早产儿严重视网膜病变的发病率、危险因素和治疗进展：一项针对70个新生儿重症监护病房的回顾性多中心队列研究","authors":"Xuting Chen, Yu Xu, Yanchen Wang, Juan Du, Falin Xu, Xinyue Gu, Yun Cao, Jianhua Sun, Mingyan Hei, Shoo Lee, Hongping Xia","doi":"10.3389/fmed.2025.1652727","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the current incidence, risk factors and treatment for severe retinopathy of prematurity (ROP) in very preterm infants in China.</p><p><strong>Methods: </strong>This was a descriptive, retrospective cohort study. The study population was very preterm infants admitted to one of the 70 neonatal intensive care units (NICUs) in the Chinese Neonatal Network who underwent ROP screening between January 2019 and December 2020. The primary outcome was severe ROP, defined as type 1 or type 2 ROP. Potential risk factors were identified based on prior evidence and statistical significance. Adjusted odds ratios with 95% confidence intervals were calculated using a multivariable multinomial logistic regression model.</p><p><strong>Results: </strong>This study included 14,670 very preterm infants, among which 17.3% had low-grade ROP, and 8.5% had severe ROP. Treatment was performed in 1,381 (4.7%) eyes of the infants, among which 1,029 (74.5%), 148 (10.7%), and 124 (9.0%) received intravitreal anti-vascular endothelial growth factor injection only, laser treatment only, and vitreoretinal surgery, respectively. Extremely preterm birth (7.61, 95% CI: 6.12-9.46), small for gestational age (SGA; 2.31, 95% CI: 1.71-3.12), outborn status (1.43, 95% CI: 1.22-1.67), 1-min Apgar score < 7 (1.30, 95% CI: 1.11-1.51), >40 days on oxygen (1.70, 95% CI: 1.37-2.10), >28 days on parenteral nutrition (PN; 1.17, 95% CI: 1-1.35), and any inotropes use (2.12, 95% CI: 1.82-2.46) were associated with increased odds of severe ROP. Antenatal steroid use (0.77, 95% CI: 0.66-0.91), large for gestational age (LGA; 0.62, 95% CI: 0.45-0.85), and surfactant treatment (0.75, 95% CI: 0.64-0.87) were associated with reduced odds of severe ROP.</p><p><strong>Conclusion: </strong>The incidence of severe ROP in very preterm infants in China was high compared to the developed countries, and intravitreal anti-VEGF injection was the preferred treatment for severe ROP.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1652727"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489369/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence, risk factors and evolving treatment of severe retinopathy of prematurity in China: a retrospective multicenter cohort study in 70 neonatal intensive care units.\",\"authors\":\"Xuting Chen, Yu Xu, Yanchen Wang, Juan Du, Falin Xu, Xinyue Gu, Yun Cao, Jianhua Sun, Mingyan Hei, Shoo Lee, Hongping Xia\",\"doi\":\"10.3389/fmed.2025.1652727\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the current incidence, risk factors and treatment for severe retinopathy of prematurity (ROP) in very preterm infants in China.</p><p><strong>Methods: </strong>This was a descriptive, retrospective cohort study. The study population was very preterm infants admitted to one of the 70 neonatal intensive care units (NICUs) in the Chinese Neonatal Network who underwent ROP screening between January 2019 and December 2020. The primary outcome was severe ROP, defined as type 1 or type 2 ROP. Potential risk factors were identified based on prior evidence and statistical significance. Adjusted odds ratios with 95% confidence intervals were calculated using a multivariable multinomial logistic regression model.</p><p><strong>Results: </strong>This study included 14,670 very preterm infants, among which 17.3% had low-grade ROP, and 8.5% had severe ROP. Treatment was performed in 1,381 (4.7%) eyes of the infants, among which 1,029 (74.5%), 148 (10.7%), and 124 (9.0%) received intravitreal anti-vascular endothelial growth factor injection only, laser treatment only, and vitreoretinal surgery, respectively. Extremely preterm birth (7.61, 95% CI: 6.12-9.46), small for gestational age (SGA; 2.31, 95% CI: 1.71-3.12), outborn status (1.43, 95% CI: 1.22-1.67), 1-min Apgar score < 7 (1.30, 95% CI: 1.11-1.51), >40 days on oxygen (1.70, 95% CI: 1.37-2.10), >28 days on parenteral nutrition (PN; 1.17, 95% CI: 1-1.35), and any inotropes use (2.12, 95% CI: 1.82-2.46) were associated with increased odds of severe ROP. Antenatal steroid use (0.77, 95% CI: 0.66-0.91), large for gestational age (LGA; 0.62, 95% CI: 0.45-0.85), and surfactant treatment (0.75, 95% CI: 0.64-0.87) were associated with reduced odds of severe ROP.</p><p><strong>Conclusion: </strong>The incidence of severe ROP in very preterm infants in China was high compared to the developed countries, and intravitreal anti-VEGF injection was the preferred treatment for severe ROP.</p>\",\"PeriodicalId\":12488,\"journal\":{\"name\":\"Frontiers in Medicine\",\"volume\":\"12 \",\"pages\":\"1652727\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489369/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fmed.2025.1652727\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1652727","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Incidence, risk factors and evolving treatment of severe retinopathy of prematurity in China: a retrospective multicenter cohort study in 70 neonatal intensive care units.
Purpose: To investigate the current incidence, risk factors and treatment for severe retinopathy of prematurity (ROP) in very preterm infants in China.
Methods: This was a descriptive, retrospective cohort study. The study population was very preterm infants admitted to one of the 70 neonatal intensive care units (NICUs) in the Chinese Neonatal Network who underwent ROP screening between January 2019 and December 2020. The primary outcome was severe ROP, defined as type 1 or type 2 ROP. Potential risk factors were identified based on prior evidence and statistical significance. Adjusted odds ratios with 95% confidence intervals were calculated using a multivariable multinomial logistic regression model.
Results: This study included 14,670 very preterm infants, among which 17.3% had low-grade ROP, and 8.5% had severe ROP. Treatment was performed in 1,381 (4.7%) eyes of the infants, among which 1,029 (74.5%), 148 (10.7%), and 124 (9.0%) received intravitreal anti-vascular endothelial growth factor injection only, laser treatment only, and vitreoretinal surgery, respectively. Extremely preterm birth (7.61, 95% CI: 6.12-9.46), small for gestational age (SGA; 2.31, 95% CI: 1.71-3.12), outborn status (1.43, 95% CI: 1.22-1.67), 1-min Apgar score < 7 (1.30, 95% CI: 1.11-1.51), >40 days on oxygen (1.70, 95% CI: 1.37-2.10), >28 days on parenteral nutrition (PN; 1.17, 95% CI: 1-1.35), and any inotropes use (2.12, 95% CI: 1.82-2.46) were associated with increased odds of severe ROP. Antenatal steroid use (0.77, 95% CI: 0.66-0.91), large for gestational age (LGA; 0.62, 95% CI: 0.45-0.85), and surfactant treatment (0.75, 95% CI: 0.64-0.87) were associated with reduced odds of severe ROP.
Conclusion: The incidence of severe ROP in very preterm infants in China was high compared to the developed countries, and intravitreal anti-VEGF injection was the preferred treatment for severe ROP.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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