Abstract:
OBJECTIVE:To determine appropriate upper limits for gestational age and birth weight when screening infants for retinopathy of prematurity (ROP). DESIGN:Retrospective survey. SETTING:Tertiary neonatal intensive care nursery. PATIENTS:Seven hundred seven infants born July 1, 1990 to June 30, 1996 and screened for ROP according to the 1988 to 1996 American Academy of Pediatrics guidelines. OUTCOME MEASURES:Maximum stage of ROP with respect to birth weight and gestational age. RESULTS:No ROP more than Stage 1 was observed in infants with gestational ages >/=32 weeks or birth weights >/=1500 g. All cases of threshold and Stage 4 ROP were confined to infants with gestational ages =30 weeks or birth weights <1200 g. CONCLUSIONS:The latest American Academy of Pediatrics screening guidelines for ROP are discretionary for infants with birth weights >1500 g or gestational ages >28 weeks. If ROP screening is limited to infants with birth weights of =1500 g, 34.2% fewer infants would require screening compared with the previous <1800 g recommendation, while missing no cases of ROP more than Stage 1. A gestational age cut-off of =28 weeks, however, is less desirable, and could potentially miss several infants with more advanced retinopathy (including Stage 4). If ROP screening criteria were instead modified to include infants of gestational ages <32 weeks, the number of patients requiring screening could be reduced 29.1% compared with the previous recommendation of <35 weeks, again without missing any cases of ROP more than Stage 1. Use of such a screening strategy (birth weight <1500 g or gestational age <32 weeks) is predicted to save in excess of 1.5 million dollars annually in the United States, while missing no cases of ROP more than Stage 1.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Wright K,Anderson ME,Walker E,Lorch Vdoi
10.1542/peds.102.1.31subject
Has Abstractpub_date
1998-07-01 00:00:00pages
31-4issue
1 Pt 1eissn
0031-4005issn
1098-4275journal_volume
102pub_type
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