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ROP rates, treatments vary internationally
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A retrospective cohort study conducted on preterm infants registered in an international database showed considerable variation in the rate of retinopathy of prematurity and ROP treatment, likely reflecting differences in care practices, diagnosis and treatment thresholds.
The International Network for Evaluating Outcomes in Neonates was formed with the objective of comparing neonatal morbidity rates, practices and standards of care in countries across the globe and currently includes 10 neonatal networks from 11 high-income countries: Australia/New Zealand, Canada, Israel, Japan, Sweden, Switzerland, Spain, the U.K., Finland and Tuscany, Italy. From this large database, 48,087 infants of 24 to 27 weeks gestational age were selected. ROP of stage 3 or higher and ROP treatment rates were calculated for each network.
Significant differences were found, with ROP rates ranging from 25.2% to 91%, and treatment rates varying from 4.3% to 30.4%, with Switzerland and Japan, respectively, at the lowest and highest ends. Lower gestational age and lower birth weight were identified as risk factors, while antenatal corticosteroids were associated with lower rates of ROP treatment.
Possible explanations for such a diverse scenario may include ethnic and genetic characteristics and variations in treatment thresholds and clinical practices, according to the authors. “Differences in ascertainment of ROP and ROP treatment thresholds may contribute to the variability observed, as well as differences in care provisions,” the authors wrote, advocating for the adoption of “common definitions to describe pathology and improve consistency in interpretation.” – by Michela Cimberle
Disclosures: The authors report no relevant financial disclosures.
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