Binenbaum G, et al. - Researchers sought to develop a birth weight (BW), gestational age (GA), and weight gain (WG) prediction model using data from a broad-risk cohort of premature infants. Evidence-based screening criteria was provided by this cohort study, broadly representative of infants who are undergoing retinopathy of prematurity (ROP) examinations. With validation, in order to reduce the number of infants who require examinations in North America, the incorporation of Postnatal Growth and ROP Study criteria into ROP screening guidelines was suggested.

Methods

• Experts conducted the Postnatal Growth and ROP Study (a retrospective multicenter cohort study) in 29 hospitals in the United States and Canada from 2006 to 2012 that included 7483 premature infants at risk for ROP with a known ROP outcome.
• They used a hybrid modeling approach that combined BW/GA criteria, weight comparison with expected growth from infants without ROP, multiple growth-interval assessments, consideration of nonphysiological WG, and user-friendly screening criteria.
• They evaluated numerous BW/GA levels, postnatal age periods, time intervals, and WG percentile thresholds to identify the most robust parameters.
• The main outcome and measures were sensitivity for Early Treatment of ROP Study type 1 ROP and potential reduction in infants who require examinations.

Results

• Findings suggested that out of 7483 infants, the median (SD) BW was 1099 (359) g, the median GA was 28 weeks (range, 22-35), 3575 (47.8%) were female, 3615 (48.4%) were white, 2310 (30.9%) were black, 233 (3.1%) were Asian, 93 (1.2%) were Pacific Islander, and 40 (0.5%) were American Indian/Alaskan Native.
• As per data, examinations were conducted in infants who met any of 6 criteria: a GA of younger than 28 weeks; a BW of less than 1051 g; a WG of less than 120 g, 180 g, or 170 g during ages 10 to 19, 20 to 29, or 30 to 39 days, respectively; or hydrocephalus.
• Results demonstrated that 459 of 459 (100%) type 1 (sensitivity, 100%; 95% CI, 99.2%-100%), 524 of 524 (100%) treated, and 466 of 472 (98.7%) type 2 cases were predicted by these criteria while reducing the number of infants who required examinations by 2269 (30.3%).