BACKGROUND & AIMS:
OBJECTIVES:To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines.
METHODS:Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register.
RESULTS:In SWEDROP, there were 1791 infants born before a GA of 32 weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (dropout rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30).
CONCLUSIONS:The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.
背景与目标:
目的:评估瑞典早产儿视网膜病变(ROP)的筛查,并调查对本筛查指南的可能修改。
方法:对瑞典胎龄(GA)为31周6天或更短的婴儿进行ROP筛查。提取了瑞典国家ROP注册机构(SWEDROP)在2008年至2009年期间的数据,并将其与国家围产期质量注册机构进行了比较。
结果:从2008年1月1日到2009年12月31日,在SWEDROP中,有32个星期的GA之前有1791例婴儿出生。另外70例婴儿在围产期质量寄存器中登记,但SWEDROP中未登记(辍学率为3.8%[70的1861名婴儿])。在终止筛查之前,有7名婴儿死亡。在最后的研究队列中(1784名婴儿),轻度ROP为15.6%,重度ROP为8.5%。在4.4%的婴儿中进行了治疗,这些婴儿出生时都没有GA超过28周。 9例出生时GA超过28周的婴儿发生了3期ROP,并自发性退步。总检查次数为9286次(GA为31周的婴儿为964次),每名婴儿的平均检查(范围)为5.2次(1-30次)。
结论:SWEDROP是ROP的质量注册机构,其全国覆盖率(即参与率)为96%。 2008年至2009年的数据表明,瑞典的筛查上限似乎有可能降低1周,仅包括GA≥30周6天或更短的婴儿。但是,这种改变应与对新生儿科医生的强烈建议相结合,以推荐重病和更“成熟”的婴儿。