Population Study Article | Published:

Prediction of ROP Treatment and Evaluation of Screening Criteria in VLBW Infants–a Population Based Analysis

Pediatric Researchvolume 84pages632638 (2018) | Download Citation

Subjects

Abstract

Background

The incidence of retinopathy of prematurity (ROP) and ROP screening criteria differ between countries. We assessed whether ROP screening could be reduced based on the local ROP incidence.

Methods

Observational cohort study of infants born in Switzerland between 2006 and 2015 <32 0/7 weeks. Chronological and postmenstrual ages at ROP treatment were analyzed. A model to identify ROP treatment on patients born between 2006 and 2012 (training set) was developed and tested on patients born between 2013 and 2015 (validation set).

Results

Of 7817 live-born infants, 1098 died within the first 5 weeks of life. The remaining 6719 infants were included into analysis. All patients requiring ROP treatment would have been identified if screening had been performed before reaching 60 days of life or 37 3/7 weeks postmenstrual age, whichever came first. The training and validation sets included 4522 and 2197 preterm infants encompassing 56 and 20 patients receiving ROP treatment, respectively. All patients would have required screening to reach 100% sensitivity. To reach a sensitivity of 95.0% and a specificity of 87.6%, we predicted a reduction in 13.2% of patients requiring screening (c-statistic = 0.916).

Conclusions

A substantial reduction of infants requiring screening seems possible, but necessitates prospective testing of new screening criteria.

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Acknowledgements

We would like to thank Karine Landgren-Hugentobler for proofreading and editing of the manuscript.

We also thank the following units for collaborating in this study of the SwissNeoNet

Aarau: Ph. Meyer9, C. Anderegg9, A. Capone Mori10, D. Kaeppeli10, S. Schulzke11, P. Weber12, G.P. Ramelli13, M. Nelle14, B. Wagner15, M. Steinlin16, S. Grunt16, R. Hassink17, T. Riedel18, E. Keller19, Ch. Killer19, K. Fuhrer20, J.-F. Tolsa21, M. Roth-Kleiner21, M. Bickle-Graz22, R. E. Pfister23, P. S. Huppi24, C. Borradori-Tolsa24, M. Stocker25, T. Schmitt-Mechelke26, F. Bauder26, V. Pezzoli27, B. Erkert28, A. Mueller28, M. Ecoffey29, A. Malzacher30, J. P. Micallef31, A. Lang-Dullenkopf32, L. Hegi33, M. von Rhein34, D. Bassler35, R. Arlettaz35, V. Bernet36, B. Latal37, G. Natalucci37

Funding

The authors have no financial relationships relevant to this article to disclose.

Author information

Affiliations

  1. Department of Neonatology, University of Basel, Children’s Hospital UKBB, 4056, Basel, Switzerland

    • Roland Gerull
    •  & Viviane Brauer
  2. Department of Neonatology, University Hospital Zurich, 8091, Zurich, Switzerland

    • Dirk Bassler
  3. Hôpital Neuchâtelois, Pediatrics, 2000, Neuchâtel, Switzerland

    • Bernard Laubscher
    •  & Mark Adams
  4. University Hospital Geneva, Neonatology, 1211, Geneva, Switzerland

    • Riccardo E Pfister
  5. Inselspital Bern, Neonatology, University of Berne, 3008, Berne, Switzerland

    • Mathias Nelle
  6. Ostschweizer Kinderspital St. Gallen, Intensive Care and Neonatology, 9006, St. Gallen, Switzerland

    • Beatrice Müller
  7. University Hospital and University of Lausanne, Clinic of Neonatology, 1011, Lausanne, Switzerland

    • Matthias Roth-Kleiner
  8. Department of Ophthalmology, University Hospital Zurich, 8091, Zurich, Switzerland

    • Christina Gerth-Kahlert
  9. Department of Neonatology, Cantonal Hospital Aarau, Children’s Clinic, Aarau, Switzerland

    • Ph. Meyer
    •  & C. Anderegg
  10. Department of Neuropaediatrics, Aarau, Switzerland

    • A. Capone Mori
    •  & D. Kaeppeli
  11. Department of Neonatology, University Children’s Hospital Basel, Basel, Switzerland

    • S. Schulzke
  12. Department of Neuropaediatrics and Developmental Medicine, Basel, Switzerland

    • P. Weber
  13. Department of Pediatrics, San Giovanni Hospital, Bellinzona, Switzerland

    • G. P. Ramelli
  14. Department of Neonatology, University Hospital Berne, Berne, Switzerland

    • M. Nelle
  15. Department of Pediatrics, Berne, Switzerland

    • B. Wagner
  16. Department of Neuropaediatrics, Berne, Switzerland

    • M. Steinlin
    •  & S. Grunt
  17. Development and Pediatric Neurorehabilitation Center, Biel, Switzerland

    • R. Hassink
  18. Department of Neonatology, Children’s Hospital Chur, Chur, Switzerland

    • T. Riedel
  19. Department of Neuropaediatrics, Chur, Switzerland

    • E. Keller
    •  & Ch. Killer
  20. Department of Neuropediatrics, Cantonal Hospital Fribourg, Fribourg, Switzerland

    • K. Fuhrer
  21. Department of Neonatology, University Hospital (CHUV), Lausanne, Switzerland

    • J.-F. Tolsa
    •  & M. Roth-Kleiner
  22. Department of Child Development, Lausanne, Switzerland

    • M. Bickle-Graz
  23. Department of child and adolescent, University Hospital (HUG), Neonatology Units, Geneva, Switzerland

    • R. E. Pfister
  24. Division of Development and Growth, Geneva, Switzerland

    • P. S. Huppi
    •  & C. Borradori-Tolsa
  25. Children’s Hospital of Lucerne, Neonatal and Paediatric Intensive Care Unit, Lucerne, Switzerland

    • M. Stocker
  26. Department of Neuropaediatrics, Lucerne, Switzerland

    • T. Schmitt-Mechelke
    •  & F. Bauder
  27. Department of Pediatrics, Regional Hospital Lugano, Lugano, Switzerland

    • V. Pezzoli
  28. Department of Pediatrics, Cantonal Hospital Muensterlingen, Muensterlingen, Switzerland

    • B. Erkert
    •  & A. Mueller
  29. Department of Pediatrics, Cantonal Hospital Neuchatel, Neuchatel, Switzerland

    • M. Ecoffey
  30. Department of Neonatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland

    • A. Malzacher
  31. Children’s Hospital St. Gallen, Neonatal and Paediatric Intensive Care Unit, St. Gallen, Switzerland

    • J. P. Micallef
  32. Department of Child Development, St. Gallen, Switzerland

    • A. Lang-Dullenkopf
  33. Department of Neonatology, Cantonal Hospital Winterthur, Winterthur, Switzerland

    • L. Hegi
  34. Social Pediatrics Center, Winterthur, Switzerland

    • M. von Rhein
  35. Department of Neonatology, University Hospital Zurich (USZ), Zurich, Switzerland

    • D. Bassler
    •  & R. Arlettaz
  36. Department of Neonatology, University Children’s Hospital Zurich, Zurich, Switzerland

    • V. Bernet
  37. Child Development Centre, Zurich, Switzerland

    • B. Latal
    •  & G. Natalucci

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Consortia

  1. on behalf of the Swiss Neonatal Network & Follow-up Group

Competing interest

The authors declare no competing interests.

Corresponding author

Correspondence to Roland Gerull.

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https://doi.org/10.1038/s41390-018-0128-3