Prevalence and predisposing factors of retinopathy of prematurity in low birth weight preterm neonates at one district of Rwanda: a case of Muhima District Hospital, Neonatal unit.

Abstract

Introduction: Recent advances in neonatal care have improved the survival rate for premature infants. Consequently, rate of complications of prematurity has increased in parallel. Retinopathy of prematurity (ROP) is worldwide among those complications, and it is the major cause of blindness in premature children in the developing and developed countries. The aim of this study was to determine the prevalence and to identify risk factors related to ROP at Muhima district hospital. Methods: This was a cross sectional study done at Muhima DH, neonatal unit, including all preterm neonates admitted in neonatology with low birth weight (LBW), less than 2500gr, born before 37 weeks of gestational age, from September 2015, until end March 2016. Indirect ophthalmoscopy has been performed between 3 to 6 weeks chronological age. Multivariate logistic regression analysis was used to examine the factors associated with occurrence of ROP. Results: A total of 148 premature babies were screened; most preterm infants born at or above 33 weeks gestational age (WGA) and between 30 - 32WGA; 85 (57.4%) and 54 (36.5%) respectively, with only 9 (6.1%) preterm babies born before 30 WGA. The smallest gestational age was 28 weeks, whereas the oldest GA was 36 weeks. The majority of them weighed more than 1500g 75 (50.7%), below 1000g were only 5 (3.4%), and the lightest weight was 930g, while the heaviest was 2300g. The overall prevalence was 14.9% for any stage of ROP, stage I was 9 (40.9%), stage II 12 (54.6%), and only 1 (4.5%) infant had ROP stage III. Four different factors were significantly associated with ROP after multivariate logistic regression: gestational age: 27 weeks to 29 weeks of GA (OR= 19.880, p=0.040), 30 weeks to 32 weeks (OR= 9.409, p=0.036), birth weight: <1000g (OR=74.164, p=0.044), 1001g-1500g (OR= 44.816, P=0.015), oxygen therapy (OR=178.009, p=0.006) and neonatal sepsis (OR=10.832, p=0.026). Conclusion: Overall prevalence of ROP was 14.9%. Low birth weight, gestational age, oxygen therapy and neonatal sepsis were the main risk factors associated with the occurrence of ROP in neonatal unit at Muhima hospital.