Resumo

GARCIA-SERRANO, J.L.; RAMIREZ-GARCIA, M.C.  e  PINAR-MOLINA, R.. Retinopathy of prematurity in multiple births: risk analysis for plus disease. Arch Soc Esp Oftalmol [online]. 2009, vol.84, n.4, pp.191-198. ISSN 0365-6691.

Purpose: To analyze the risk factors associated with plus disease in retinopathy of prematurity (ROP). Method: Over a period of 8.5 years we carried out a prospective study of ROP in twins and triplets. Fifty-four multiple-birth infants with low birth weight (≤1500 g) and low gestational age (32≤ weeks) were admitted to the University Hospital of Granada. Results: Logistic regression analyses showed the following variables to be associated with an increased risk of plus disease: severe ROP, large area of avascular retina, low gestational age, low birth weight, a patent ductus arteriosus, length of mechanical ventilation, adverse events increase, low 5 min Apgar scores and poor postnatal weight gain (in the first 4 to 6 weeks of life). Using multiple logistic regression, only the grade of ROP (OR: 5.5; p < 0.009) and poor postnatal weight gain (OR: 0.58; p < 0.04) were predictive factors of development of plus disease. Infants with «plus» disease gained an average 3.9 ± 3.1 g/day in the first 6 weeks of life, compared to a mean of 11.84 ± 8.3 g/day for those without plus disease (p < 0.0001). Conclusion: Advanced ROP stages and poor weight gain were the most significant factors associated with plus disease. Twins who gained weight at more than 7 g/day in the first 4-6 weeks of life had a significantly reduced risk of plus disease. A good weight gain is an effective strategy against avoidable blindness due to ROP.

Palavras-chave : Retinopathy of prematurity; plus disease; risk factors; weight gain; multiple-birth; adverse effects; Apgar score.

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