ITALIAN MULTICENTER STUDY ON RETINOPATHY OF PREMATURITY

The aim of this prospective multicentre study was to evaluate the infl uence of a number of perinatal factors on the development of ROP in hi gh risk preterm infants with gestational age less than or equal to 30 weeks. All infants consecutively born in, or transferred to, one of th e 14 participating centres from 1 January 1992 through 31 December 199 3, who had a gestational age of 30 weeks or less and no congenital ano malies and survived to the age of 6 months, were included in the study . Of the 380 infants with mean +/- SD gestational age of 28.4 +/- 1.6 weeks (range 23-30 weeks) and birth weight of 1157 +/- 335 g (range 48 5-2480 g) that were eligible for the study, 82 (21.5%) developed ROP s tage 1 or 2 and 57 (15%) ROP stage 3 or 3+. Step-wise logistic regress ion analysis showed that the following factors had a significant predi ctive value for the development of ROP stage 3 or 3+: gestational age (Odds Ratio (OR)=0.6144 for each increment of 1 week of gestational ag e), birth weight (OR=0.843 for each increment of 100 g of birth weight ), prenatal steroids (OR 4.044 for lacking or incomplete prophylaxis), RDS (OR 2.294), oxygen dependency at 60 days (OR 2.085), necrotising enterocolitis (OR 2.597). Conclusion This study confirms the role of p rematurity, low birth weight and RDS in the pathogenesis of ROP, and e mphasises the importance of prenatal steroid prophylaxis of RDS in ver y preterm infants. Furthermore, our data suggest that infants with oxy gen dependency at 60 days or necrotising enterocolitis are at very hig h risk of developing ROP.