Original Article

Journal of Perinatology (2005) 25, 36–40. doi:10.1038/sj.jp.7211203 Published online 14 October 2004

Barriers to Screening Infants for Retinopathy of Prematurity after Discharge or Transfer from a Neonatal Intensive Care Unit

Financial Support: Michigan Department of Community Health Grant.

Mohammad A Attar MD1, Molly R Gates MS, RNC1, Ann M Iatrow BSN, MPH, RN1, Sylvia W Lang PhD1 and Susan L Bratton MD, MPH1

1Department of Pediatrics and Communicable Diseases, University of Michigan, MI, USA

Correspondence: Mohammad A. Attar, MD, F5790 Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0254, USA

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Abstract

OBJECTIVE:

 

To assess neonatal intensive care unit (NICU) practices affecting screening and follow-up for retinopathy of prematurity (ROP).

METHODS:

 

Retrospective study of infants at risk for ROP, eligible for back transport, admitted to a regional NICU from January 1, 1999 until May 31, 2002. Patients failed to receive needed follow-up for ROP after discharge or transfer from a NICU, if we could not verify their ROP screening follow-up within 1 month.

RESULTS:

 

A total of 74 infants were identified to need follow-up eye care. Infants who did not receive the follow-up care had greater mean gestational age (mean SD; 30.7plusminus2.3 vs 29.6plusminus2.5 weeks, p=0.05) and birth weights (mean SD; 1581plusminus366 vs 1360plusminus508 g, p=0.007), compared to infants who received the recommended care. Infants transported back to the community hospital were significantly more likely to miss follow-up eye care compared to infants discharged from the regional center (relative risk 2.81, 95% confidence interval (CI) (1.09 to 7.20)). Infants not screened for ROP in the NICU had greater risk for missing follow-up care compared to infants who had their first retinal examination in the NICU (relative risk 4.25, 95% CI (1.42 to 12.73)).

CONCLUSIONS:

 

Infants transferred back or discharged from the NICU before ROP screening represent a high-risk group for not receiving follow-up eye care.

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