Dépistage de la rétinopathie des prématurés chez les grands prématurés : cohorte Epipage 2

Abstract : Retinopathy of prematurity (ROP) is a severe blinding disease requiring screening which compliance is rarely evaluated. The objective was to determine the prevalence of fundus examination in infants born very preterm and the individual- and center-related factors associated with ROP screening in France. To do so, data were extracted from EPIPAGE-2, an observational cohort of prematures born in France in 2011.Children born before 32 WG without severe malformation alive at the recommended time for ROP screening were included and analyzed using mixed model. In total, 2169/3077 (70.5%) of the children eligible for screening underwent a fundus examination (from 96% at 24 WG to 50% at 31 WG). The infant characteristics associated with fundus examination were small gestational age, low birth weight, severe bronchopulmonary dysplasia, severe neurological lesions and a transfer to another neonatal unit at the recommended screening schedule. Odd of screening was increased for infants hospitalized in units using wide-angle imaging (odds ratio [OR] 2.65 [95% confidence interval (CI) 1.17-6.01]). Level of care, administrative status and activity volume were not associated with ROP screening. Among screened children, 1641/2169 (75.7%) were screened on time. Screening performed on time was associated with high gestational age and use of wide-angle imaging (OR 2.20, 95% CI [1.06-4.58]); delayed examination was associated with low birth weight, severe bronchopulmonary dysplasia and necrotizing enterocolitis. To conclude, children the most at risk for ROP were the best screened but often with a delay. The better compliance of neonatal units using wide-angle imaging systems supports its use.
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Master Thesis
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Thibaut Chapron. Dépistage de la rétinopathie des prématurés chez les grands prématurés : cohorte Epipage 2. Médecine humaine et pathologie. 2018. ⟨dumas-02176410⟩

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