Regional variations in retinopathy of prematurity incidence for preterm infants <32 weeks' gestation in China

J Du; X Chen; Y Wang; Z Yang; D Wu; Q Zhang; Y Liu; X Zhu; S Jiang; Y Cao; C Chen; L Du; W Zhou; S K Lee; H Xia; M Hei; Chinese Neonatal Network

doi:10.1016/j.puhe.2023.10.033

Regional variations in retinopathy of prematurity incidence for preterm infants <32 weeks' gestation in China

Public Health. 2024 Jan:226:91-98. doi: 10.1016/j.puhe.2023.10.033. Epub 2023 Nov 28.

Authors

J Du¹, X Chen², Y Wang³, Z Yang¹, D Wu¹, Q Zhang¹, Y Liu¹, X Zhu¹, S Jiang⁴, Y Cao⁴, C Chen⁴, L Du⁵, W Zhou⁴, S K Lee⁶, H Xia², M Hei⁷; Chinese Neonatal Network

Collaborators

Chinese Neonatal Network:
S K Lee, C Chen, L Du, W Zhou, Y Cao, X Chen, H Zhang, X Tian, J Shi, Z Li, C Yang, L Liu, Z Yang, J Fu, Y Ji, D Chen, C Yang, R Chen, X Peng, R Shan, S Han, H Wu, L Wang, Q Wei, M Li, Y Dai, H Jiang, W Kang, X Gong, X Zhong, Y Shi, S Jiang, B Sun, L Li, Z Lin, J Liu, J Pan, H Xia, X Li, F Xu, Y Qiu, L Ma, L Yang, X He, Y Li, D Zhuang, Q Zhang, W Dong, J Sun, K Liang, H Wang, J Feng, L Chen, X Lin, C Jiang, C Niebl, L Zeng, M Hei, H Zhu, H Mi, Z Yin, H Song, H Wang, D Li, Y Gao, Y Wang, L Dai, L Zhang, Y Li, Q Zhang, G Ding, J Wang, X Chen, Z Wang, Z Tang, X Ma, X Zhang, X Zhang, F Wu, Y Chen, Y Wu, J Ting

Affiliations

¹ Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China.
² Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
⁴ NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China; Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
⁵ Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
⁶ Maternal-Infant Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
⁷ Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China. Electronic address: heimingyan@bch.com.cn.

PMID: 38029699
DOI: 10.1016/j.puhe.2023.10.033

Abstract

Objectives: National-level data on the incidence of retinopathy of prematurity (ROP) in different regions of China is insufficient. This study aimed to compare ROP incidences and care practices in different regions of China and their relationship with regional gross domestic product (GDP) per capita.

Study design: Retrospective cohort study.

Methods: All infants born at <32 weeks gestational age (GA) and admitted to 70 neonatal intensive care units (NICUs) from January 1, 2019, to December 31, 2020, were enrolled. Hospitals were categorised into three regional groups according to geographical locations and GDP per capita from high to low: Eastern, Central, and Western China. The incidence of death or ROP, and care practices were compared among the groups.

Results: A total of 18,579 infants were enrolled. Median GA was 29.9 (interquartile range 28.4-31.0) weeks and birth weight was 1318.1 (317.2) g. The percentage of GA <28 weeks, complete administration of antenatal steroids, and weight gain velocity during NICU stay were highest in Eastern China and lowest in Western China (all P < 0.01). In Eastern, Central, and Western China, the rates of death or any stage of ROP were 33.3%, 38.5%, and 39.2%, respectively (P < 0.01).

Conclusions: There were considerable regional disparities in ROP incidence in preterm infants with GA <32 weeks in China. The incidence of death or ROP ranged from high to low in Western, Central, and Eastern China.

Keywords: China; Gross domestic product; Infants, Premature; Retinopathy of prematurity.

MeSH terms

Birth Weight
China / epidemiology
Female
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature*
Pregnancy
Retinopathy of Prematurity* / epidemiology
Retrospective Studies
Risk Factors