미숙아망막병증의 발생 및 진행과 체중증가율과의 연관성에 관한 분석
Association between Weight Gain and the Occurrence and Severity of Retinopathy of Prematurity
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목적: 미숙아망막병증의 발생 및 진행과 출생 후 체중증가율과의 연관성에 대해 분석하였다. 대상과 방법: 서울대학교어린이병원 신생아중환자실에서 집중치료를 받았던 275명의 환아들을 안저검진 소견을 바탕으로 세 군(1군:미숙아망막병증이 없는 경우, 2군: 경도의 미숙아망막병증, 3군: 중등도 이상의 미숙아망막병증)으로 분류하였다. 각 군의 출생 후 평균주당 체중증가율 및 병의 발생과 관련된 위험인자에 대해 분석하였다. 결과: 미숙아망막병증의 정도가 중할수록 출생 후 평균 주당 체중증가율이 낮아지는 경향을 보였으나(1군: 13.54 ± 11.87%; 2군: 12.38± 1.33%; 3군: 11.41 ± 1.70%), 유의한 차이는 없었으며 병이 발생한 군과 발생하지 않은 군 간에도 유의한 차이는 없었다. 미숙아망막병증이 발생한 군에서는 유의하게 출생체중, 출생 시 재태연령 및 태아 출생 후 아프가 점수가 낮았으며 산소 치료의 기간이 길었고,신생아 호흡 곤란 증후군 및 폐이형성의 이환율이 높았다. 결론: 미숙아망막병증의 발생 및 진행을 예측하는 데 있어 출생 후 체중증가율을 주된 예후인자로 삼는 데는 한계가 있다.
Abstract
Purpose: To evaluate the association between the occurrence and severity of retinopathy of prematurity (ROP) and postnatal weight gain. Methods: The medical records and mean rate of postnatal weekly weight gain measurements for 275 premature infants were retrospectively reviewed. According to fundus examination findings, 275 infants were divided into the following three groups according to the international classification of ROP: Group I; infants with no ROP, Group II; infants with mild ROP (stage 1 or stage 2 with no additional disease or spontaneous regression), and Group III; infants with moderate to severe ROP (stage 3, threshold or Type I ROP according to ET-ROP). The mean rates of postnatal weekly weight gain in each group were compared and other risk factors were evaluated. Results: There was a tendency of decrement in the mean rate of postnatal weekly weight gain in association with the severity of the disease (Group I: 13.54 ± 11.87%; Group II: 12.38 ± 1.33%; Group III: 11.41 ± 1.70%) but no statistical significance was found. Additionally, there was no statistically significant difference between the group without ROP and the group with ROP. Significant risk factors related to ROP were low birth weight, low gestational age, low Apgar score,long duration of oxygen therapy, high incidence of respiratory distress syndrome and bronchopulmonary dysplasia. Conclusions: The change in postnatal weight gain has limited usage as a main prognostic factor in predicting the progression of ROP.
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