Abstract
Neonatal intensive care unit (NICU) practices may influence the delivery of ophthalmology care for infants eligible for back transfer to a referring community hospital. We conducted this study to assess barriers to screening for Retinopathy of Prematurity (ROP) after discharge or transfer from a NICU.
Study Design: Retrospective study of 78 infants who needed ophthalmology examinations at the time of their discharge or transfer from the NICU. These infants either needed screening for ROP or had retinal examinations in the NICU and needed further follow-up.
Results: 64% of infants received appropriate eye care. Infants who did not receive the follow-up care had greater mean gestational age (mean SD; 30.7±2.3 vs. 29.4±2.6 weeks, p=0.02) and birth weights (mean SD; 1581±366 vs. 1329±504 gm, p=0.007) compared to infants who received the recommended care. There were no statistical differences between the two groups when comparing their race, maternal age, maternal marital status, insurance coverage, or site of birth. Forty-three (55.1%) infants were transferred back, 26 (33.3%) infants were discharged home from the NICU, while nine (11.6%) infants were discharged home from the regional center after their transfer to the general pediatrics service. Infants discharged from the NICU were significantly more likely to receive recommended eye care compared to infants transported back to the community hospital or transferred to the pediatric service at the regional center (Relative Risk Ratio 1.5, 95% confidence interval 1.1–2.1, p=0.01). Infants transferred or discharged from the NICU not screened for ROP (n=49) had lower completion rates compared to infants who had their first retinal examination in the NICU and needed follow-up (n=29) (89% vs. 49%, p<0.0001). Infants whose ophthalmology follow up was recommended in the discharge summary and had their appointments arranged prior to discharging them from the community hospital or the regional center were ten time more likely to get the appropriate eye care (Relative Risk Ratio 10.7, 95% Confidence Interval 2.8–40.3, p<0.0001) compared to infants who did not have arrangements and recommendations. Parents were compliant (n=56, 89%) with pre-arranged appointments.
Conclusions: Infants transferred back or discharged from the NICU before having a retinal examination represent a high-risk group for not receiving eye screening. Scheduling appointments for these infants when they leave the NICU may improve their ROP screening and care.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Attar, M., Gates, M., Iatrow, A. et al. Barriers To Screening Infants for Retinopathy of Prematurity After Discharge or Transfer From a Neonatal Intensive Care Unit.. Pediatr Res 56, 671 (2004). https://doi.org/10.1203/00006450-200410000-00050
Issue Date:
DOI: https://doi.org/10.1203/00006450-200410000-00050