中国妇幼健康研究2025，Vol.36Issue(7)：58-63,6.DOI:10.3969/j.issn.1673-5293.2025.07.008
胎龄小于32周超低出生体重儿早产儿视网膜病变的危险因素分析及预测指标研究
Risk factors and predictive markers for retinopathy of prematurity in extremely low birth weight infants born before 32 weeks of gestation
摘要
Abstract
Objective To analyze the risk factors for retinopathy of prematurity(ROP)in extremely low birth weight(ELBW)infants with a gestational age of less than 32 weeks and to explore predictive indicators of ROP occurrence,aiming to provide a scientific basis for precise prevention strategies and improved prognosis.Methods This retrospective study included 145 ELBW infants with a gestational age of＜32 weeks who were hospitalized at Dongguan Maternal and Child Health Hospital between January 2016 and June 2023.According to retinal screening results,infants were divided into an ROP group(n=86)and a non-ROP group(n=59).Clinical characteristics and laboratory indicators were compared between the two groups to identify risk factors for ROP.Results Univariate analysis showed statistically significant differences between the two groups in terms of small for gestational age status,premature rupture of membranes,maternal gestational hypertension,maternal gestational diabetes mellitus,and rate of in vitro fertilization and embryo transfer(x2=4.149,4.722,7.879,5.358 and 6.079,respectively,P＜0.05).The ROP group had significantly higher rates of bronchopulmonary dysplasia(BPD),more frequent red blood cell transfusions,longer durations of invasive ventilation,and total mechanical ventilation compared to the non-ROP group(x2/Z=3.860,-2.505,-3.070 and-3.021,respectively,P＜0.05).Significant differences were also observed in hemoglobin,C-reactive protein,activated partial thromboplastin time(APTT),and urea levels(t/Z=2.070,-2.525,-2.258 and-2.834,respectively,P＜0.05).Multivariate binary logistic regression identified maternal gestational diabetes(OR=3.605,95％CI:1.385-9.387)and total mechanical ventilation duration(OR=1.028,95％CI:1.012-1.044)as independent risk factors for ROP(P＜0.05).Receiver operating characteristic(ROC)curve analysis demonstrated that total mechanical ventilation duration had moderate predictive value for ROP(AUC=0.648,95％CI:0.564-0.725),with a sensitivity of 62.8％,specificity of 62.1％,and a cutoff value of 43.55 days.Conclusion Maternal gestational diabetes and prolonged total mechanical ventilation are independent risk factors for ROP in ELBW infants born before 32 weeks of gestation.Moreover,total mechanical ventilation duration shows moderate predictive value for the development of ROP.关键词
超低出生体重儿/早产儿视网膜病变/危险因素/预测价值Key words
extremely low birth weight infant/retinopathy of prematurity/risk factor/predictive value分类
医药卫生引用本文复制引用
陈嘉雯,李敏许,阮敏仪,骆庆明..胎龄小于32周超低出生体重儿早产儿视网膜病变的危险因素分析及预测指标研究[J].中国妇幼健康研究,2025,36(7):58-63,6.基金项目
东莞市社会科技发展项目(20231800905282) （20231800905282）
