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Swedish National Register for Retinopathy of Prematurity (SWEDROP) and the Evaluation of Screening in Sweden

Journal article
Authors G. E. Holmstrom
Ann Hellström
P. G. Jakobsson
P. Lundgren
K. Tornqvist
A. Wallin
Published in Archives of Ophthalmology
Volume 130
Issue 11
Pages 1418-1424
ISSN 0003-9950
Publication year 2012
Published at Institute of Neuroscience and Physiology
Pages 1418-1424
Language en
Links dx.doi.org/10.1001/archophthalmol.2...
Keywords extremely preterm infants, active perinatal-care, weeks gestation, risk-factors, born, rop
Subject categories Ophthalmology

Abstract

Objectives: To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines. Methods: Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register. Results: In SWEDROP, there were 1791 infants born before a GA of 32weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (drop-out rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30). Conclusions: The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.

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