ImportanceThe incidence of retinopathy of prematurity (ROP) has been increasing in the US since 2003. Understanding the progression of and racial disparities in ROP incidence in California can provide a contrasting perspective that may guide future research and practice in the management and prevention of ROP.ObjectiveTo describe how the screening and incidence of ROP among very preterm infants in California changed from January 1, 2012, to December 31, 2021.Design, Setting, and ParticipantsThis study used a cohort of very preterm infants (defined as infants born prior to 32 weeks’ gestational age or weighing less than 1500 g) admitted to 60 neonatal intensive care units across California from January 1, 2012, to December 31, 2021. Among this cohort, several factors were examined, including (1) the clinical and sociodemographic covariates of the population with and without ROP, (2) trends in screening for ROP, and (3) the incidence of ROP in total and by race and ethnicity. Data analysis was performed in April 2024.ExposuresRace and ethnicity and other birthing parental and infant descriptive characteristics.Main Outcomes and MeasuresIncidence rates of ROP and severe ROP. The primary measures were rates of ROP screening and incidence rates of ROP and severe ROP. Time trends in the risk of ROP and severe ROP were estimated using robust Poisson regression models.ResultsIn this cohort of 39 269 very preterm infants (<32 weeks’ gestational age) eligible for ROP screening, the mean (SD) infant gestational age was 28.6 (2.6) weeks. The mean (SD) birth weight was 1075 (274) g, and 48.6% of infants were female. The birthing parents of the population were 12.6% Asian, 13.3% Black, 44.9% Hispanic White or Hispanic other race, 0.7% Native American/Alaskan, 24.7% non-Hispanic White, and 1.0% Pacific Islander. From January 1, 2012, to December 31, 2021, in California, ROP screening rates remained steady at 95% or greater for eligible infants less than 30 weeks of gestational age for all race and ethnic subgroups. In this study cohort among all very preterm infants (<32 weeks’ gestational age), the incidence of ROP decreased from 31% in 2012 to 29% in 2021. Incidence rates of ROP among Asian and Hispanic individuals decreased the most quickly compared to other racial and ethnic groups, narrowing disparities.Conclusions and RelevanceIn this cohort study, in contrast to increasing national trends, the total incidence of and racial and ethnic disparities in ROP incidence remained steady or decreased from 2012 to 2021 in California.

中文翻译：

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2012 年至 2021 年加利福尼亚早产儿早产儿视网膜病变的趋势


重要性自 2003 年以来，美国早产儿视网膜病变 （ROP） 的发病率一直在增加。了解加利福尼亚 ROP 发病率的进展和种族差异可以提供一个对比鲜明的视角，可能指导未来管理和预防 ROP 的研究和实践。目的描述从 2012 年 1 月 1 日到 12 月 31 日，加利福尼亚极早产儿 ROP 的筛查和发病率如何变化，2021.Design、环境和参与者本研究使用了一组极早产儿（定义为胎龄在 32 周之前出生或体重低于 1500 克的婴儿）从 1 月 1 日起入住加利福尼亚州 60 个新生儿重症监护病房， 2012 年至 2021 年 12 月 31 日。在这个队列中，检查了几个因素，包括 （1） 有和没有 ROP 的人群的临床和社会人口学协变量，（2） ROP 筛查的趋势，以及 （3） ROP 的总发生率以及按种族和民族划分的 ROP 发生率。数据分析于 2024 年 4 月进行。主要结局和测量ROP 和严重 ROP 的发生率。主要指标是 ROP 筛查率以及 ROP 和严重 ROP 的发生率。使用稳健的泊松回归模型估计 ROP 和严重 ROP 风险的时间趋势。结果在这个包含 39 269 名极早产儿 （<32 周胎龄）符合 ROP 筛查条件，平均 （SD） 婴儿胎龄为 28.6 （2.6） 周。平均 （SD） 出生体重为 1075 （274） g，48.6% 的婴儿为女性。人口的出生父母是 12.6% 的亚裔，13.3% 的黑人，44.9% 的西班牙裔白人或其他种族，0.7% 的美洲原住民/阿拉斯加人，24 岁。7% 的非西班牙裔白人和 1.0% 的太平洋岛民。从 2012 年 1 月 1 日到 2021 年 12 月 31 日，在加利福尼亚州，所有种族和族裔亚组的胎龄小于 30 周的合格婴儿的 ROP 筛查率稳定在 95% 或更高。在该研究队列中，所有极早产儿 （<胎龄 32 周），ROP 的发病率从 2012 年的 31% 下降到 2021 年的 29%。与其他种族和族裔群体相比，亚裔和西班牙裔个体的 ROP 发病率下降得最快，缩小了差异。结论和相关性在这项队列研究中，与不断增长的全国趋势相反，从 2012 年到 2021 年，加利福尼亚州 ROP 发病率的总发生率以及种族和民族差异保持稳定或下降。