Document Type : systematic review

Authors

1 Assistant Professor of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine Emam Khomeini Hospital, Ilam University of Medical sciences, Ilam, Iran 2- Assistant Professor of Pediatrics, Department of Pediatrics, Ilam University of Medical sciences, Ilam, Iran

2 1 Assistant Professor of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine Emam Khomeini Hospital, Ilam University of Medical sciences, Ilam, Iran. 2 Assistant Professor of Pediatrics, Department of Pediatrics, Ilam University of Medical sciences, Ilam, Iran.

3 Department of Ophthalmology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran

Abstract

Background: Retinopathy of Prematurity (ROP) is a disease in the retina of premature infants, which is one of the preventable causes of blindness in children.
Methods: the present study is performed with the purpose of determining the prevalence and outcomes of ROP in Iran through a systematic review and meta-analysis.
Study design: All original published articles on the prevalence of ROP in premature infants in Iran were included in the study. On the other hand, intervention articles, meta-analysis, case reports, congress articles, medical dissertations, and articles with low quality were excluded from the study.
Results: 53 articles were included in the meta-analysis stage. Based on the results, the overall prevalence of ROP in Iran was 22.2% (95% CI: 18.5-26.5); the overall prevalence of the disease in ZONE I was 10.5% (95% CI: 3.0-30.6), the overall prevalence of the disease was 45.5% (95% CI: 33.8-57.8) in ZONE II, and 43.8% (95% CI: 25.1-64.4) in ZONE III. Regarding the stage of the disease, rate of 39.9% (95% CI: 29.2–51.7) was reported in STAGE I, rate of 30.3% (95% CI: 21.8–40.5) in STAGE II, and 14.9% (95% CI: 11.0 -19.9) in STAGE III.
Conclusion: Considering the high prevalence of ROP in premature infants in Iran, it is suggested to take necessary preventive measures in this field.

Keywords

  1. Azami M, Badfar G, Shohani M, Mansouri A, Soleymani A, Shamloo MBB, YektaKooshali MH, Nasirkandy MP: The prevalence of depression in pregnant Iranian women: A systematic review and meta-analysis. Iranian Journal of Psychiatry and Behavioral Sciences 2018, 12(3).
  2. Sayehmiri F, Kiani F, Sayehmiri K, Maleki F, Ahmadi M, Shohani M: Prevalence of polycystic ovary syndrome in Iranian women: a systematic review and meta-analysis. 2014.
  3. Samieipour S, Tavassoli E, Heydarabadi A, Daniali S, Alidosti M, Kiani F, Pakseresht M: Effect of calcium and vitamin B1 on the severity of premenstrual syndrome: a randomized control trial. International Journal of Pharmacy and Technology 2016, 8(3):18706-18717.
  4. Caberry WY, Popovic MM, Dhoot AS, Arjmand P, Muni RH, Tehrani NN, Mireskandari K, Kertes PJ: Demographic risk factors of retinopathy of prematurity: a systematic review of population-based studies. Neonatology 2022, 119(2):151-163.
  5. Norollahi S, Mozafari A, Azami G, Shafiei E: Respiratory Distress and Meconium Aspiration Syndrome: Effect of Neonatal Resuscitation Program (NRP) in Ilam, Iran. Iranian Journal of Pediatrics 2021, 31(3).
  6. HOSSEINI SH, REZAIAN M, Alinejad A, ZARE M, PANAHANDEH M, SHAFIEI E, JALILIAN SM, SARAEI N, Zahraei S, NOUROLLAHI10 S: Investigation of Meconium Aspiration Syndrome in Newborns, after NRP Protocol Changing. Pakistan Journal of Medical & Health Sciences 2020, 14(4):1848-1851.
  7. Yau GS, Lee JW, Tam VT, Liu CC, Yip S, Cheng E, Chu BC, Yuen CY: Incidence and risk factors of retinopathy of prematurity from 2 neonatal intensive care units in a Hong Kong Chinese population. The Asia-Pacific Journal of Ophthalmology 2016, 5(3):185-191.
  8. Yucel OE, Eraydin B, Niyaz L, Terzi O: Incidence and risk factors for retinopathy of prematurity in premature, extremely low birth weight and extremely low gestational age infants. BMC Ophthalmology 2022, 22(1):367.
  9. Novella CF, Viejo IG, Royo VP, Fernández RM, Iztueta MG, Calvo JP, Gómez JA, Palacios PT, Begué NM, Wolley-Dod C: Screening program for retinopathy of prematurity in Spain. Archivos de la Sociedad Española de Oftalmología (English Edition) 2013, 88(5):184-188.
  10. Wang X, Tang K, Chen L, Cheng S, Xu H: Association between sepsis and retinopathy of prematurity: a systematic review and meta-analysis. BMJ open 2019, 9(5):e025440.
  11. Villamor-Martinez E, Cavallaro G, Raffaeli G, Mohammed Rahim OM, Gulden S, Ghazi AM, Mosca F, Degraeuwe P, Villamor E: Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis. PloS one 2018, 13(10):e0205838.
  12. Yim C-L, Tam M, Chan H-L, Tang S-M, Au SC, Yip WW, Ko ST, Rong SS, Chen LJ, Ng DS-C: Association of antenatal steroid and risk of retinopathy of prematurity: a systematic review and meta-analysis. British Journal of Ophthalmology 2018, 102(10):1336-1341.
  13. Azami M, Jaafari Z, Rahmati S, Farahani AD, Badfar G: Prevalence and risk factors of retinopathy of prematurity in Iran: a systematic review and meta-analysis. BMC ophthalmology 2018, 18(1):1-14.
  14. Ojaghi H, Fekri Y, Momeni N, Amani F: Retinopathy of prematurity (ROP) in Ardebil (North West of Iran): Prevalence and Risk factors. Pakistan Journal of Medical and Health Sciences 2021, 15(5):1557-1563.
  15. Naderian G, Iranpour R, Mohammadizadeh M, Fazel Najafabadi F, Badiei Z, Naseri F, Naderian M, Sajadi V: The Frequency of Retinopathy of Prematurity in Premature Infants Referred to an Ophthalmology Clinic in Isfahan. Journal of Isfahan Medical School 2011, 29(128):126-130.
  16. Abrishami M, Maemori GA, Boskabadi H, Yaeghobi Z, Mafi-Nejad S, Abrishami M: Incidence and risk factors of retinopathy of prematurity in mashhad, northeast iran. Iran Red Crescent Med J 2013, 15(3):229-233.
  17. Nakhshab M, Ahmadzadeh Amiri A, Dargahi S, Farhadi R, Yazdani J: The Incidence Rate of Retinopathy of Prematurity and Related Risk Factors: a Study on premature neonates hospitalized in two hospitals in Sari, Iran, 2014-2015. Journal of Kerman University of Medical Sciences 2016, 23(3):296-307.
  18. Fayazi A, Fayzollazade M, GHolzar A: Prevalence of retinopathy in preterm infants admitted to neonatal intensive care unit of Alzahra hospital in Tabriz. J Tabriz Univ Med Sci 2009, 30(4):63-66.
  19. Afarid M, Hosseini H, Abtahi B: Screening for retinopathy of prematurity in South of Iran. Middle East African Journal of Ophthalmology 2012, 19(3):277-281.
  20. Bayat-Mokhtari M, Pishva N, Attarzadeh A, Hosseini H, Pourarian S: Incidence and Risk Factors of Retinopathy of Prematurity among Preterm Infants in Shiraz/Iran. Iran J Pediatr 2010, 20(3):303-307.
  21. Kasiri N, Kasiri A, Farrahi F, Mirdehghan MS, Kasiri R: Frequency of retinopathy of prematurity at a tertiary referral center. Medical hypothesis discovery and innovation in ophthalmology 2021, 10(4):179-184.
  22. Haghshenas Mojaveri M, Rasoulinejad S: The Relationship between Maternal and Neonatal Diseases and Retinopathy of Prematurity and Its Progression. Journal of Babol University of Medical Sciences 2021, 23(1):323-330.
  23. Mansouri M, Hemmatpour S, Sedighiani F, Ghamari M, Chavoshi D: Factors associated with retinopathy of prematurity in hospitalized preterm infants in Sanandaj, Iran. Electronic physician 2016, 8(9):2931.
  24. Alizadeh Y, Zarkesh M, Moghadam RS, Esfandiarpour B, Behboudi H, Karambin M-M, Heidarzade A: Incidence and risk factors for retinopathy of prematurity in North of Iran. Journal of ophthalmic & vision research 2015, 10(4):424.
  25. Daraie G, Nooripoor S, Ashrafi AM, Ghorbani R: Incidence of retinopathy of prematurity and some related factors in premature infants born at Amir –al- Momenin hospital in Semnan, Iran. Koomesh journal 1394, 17(2):297-303.
  26. Sadeghzadeh M, Khoshnevisasl P, Parvaneh M, Mousavinasab N: Early and Late Outcome of Premature Newborns with History of Neonatal Intensive Care Units Admission at 6 Years Old in Zanjan, Northwestern Iran. Iranian Journal of Child Neurology 2016, 10(2):67.
  27. Abbasi N, Ramezani M, Shoeibi N, Vashani HB: A study of the prevalence and severity of retinopathy of prematurity in East of Iran during 2015–2017: A descriptive cross-sectional study. Journal of Neonatal Nursing 2022, 28(4):244-248.
  28. Babaei H, Ansari MR, Alipour AA, Ahmadipour S, Safari-Faramani R, Vakili J: Incidence and risk factors for retinopathy of prematurity in very low birth weight infants in Kermanshah, Iran. World Appl Sci J 2012, 18(5):600-604.
  29. Boskabadi H, Abrishami M, Moradi A, Zakerihamidi M: Comparison of vitamin D levels in premature infants with and without retinopathy of prematurity. Archives of Iranian Medicine 2022, 25(4):209.
  30. Naseh A, Dastjani-Farahani A, Yaghmaii B, Shariati MK, Taslimi-Taleghani N, Palizban-Kermanshahi F: Retinopathy Screening of Premature Neonates Born at Gestational Age 32-36 Weeks. Iranian Journal of Neonatology 2022, 13(3).
  31. Karkhaneh R, Shokravi N: Assessment of retinopathy of prematurity among 150 premature neonates in Farabi Eye Hospital. Acta Medica Iranica 2001:35-38.
  32. Ghaseminejad A, Niknafs P: Distribution of retinopathy of prematurity and its risk factors. Iranian journal of pediatrics 2011, 21(2):209.
  33. Ahmadpour‐Kacho M, Jashni Motlagh A, Rasoulinejad SA, Jahangir T, Bijani A, Zahed Pasha Y: Correlation between hyperglycemia and retinopathy of prematurity. Pediatrics International 2014, 56(5):726-730.
  34. Khalesi N, Shariat M, Fallahi M, Rostamian G: Evaluation of risk factors for retinopathy in preterm infant: a case-control study in a referral hospital in Iran. Minerva pediatrica 2015, 67(3):231-237.
  35. MOUSAVI SZ, Karkhaneh R, ROUHIPOUR R, NILI AM, Ghalichi L, GHASEMI F, RIAZI EM: Screening for retinopathy of prematurity: the role of educating the parents. 2010.
  36. Khorshidifar M, Nikkhah H, Ramezani A, Entezari M, Daftarian N, Norouzi H, Shahiari M, Radfar M, Norinia R, Karimi S: Incidence and risk factors of retinopathy of prematurity and utility of the national screening criteria in a tertiary center in Iran. International journal of ophthalmology 2019, 12(8):1330.

37. Feghhi M, Altayeb SMH, Haghi F, Kasiri A, Farahi F, Dehdashtyan M, Movasaghi M, Rahim F: Incidence of retinopathy of prematurity and risk factors in the south-western region of Iran. Middle 

East African journal of ophthalmology 2012, 19(1):101.

  1. Farajzadeh M, Badri F, Jafari F, Ghawsi S: Incidence of retinopathy of prematurity in premature infants and its related factors. Scientific Journal of Nursing, Midwifery and Paramedical Faculty 2020, 6(2):1-10.
  2. Basiri B, Sabzehei MK, Shokouhi Solgi M, Akbarzadeh S, Ivazeh S: Frequency and risk factors of retinopathy of prematurity in newborns admitted to neonatal intensive care unit in Hamadan. Avicenna Journal of Clinical Medicine 2019, 26(1):44-50.
  3. Alizadeh Y, Behboudi H, Dourandeesh M, Soltani-Moghadam R, Akbari M, Medghalchi A, Azaripour E, Moravvej Z: Retinopathy of prematurity: applicability of international and national screening guidelines in the north of Iran. The Turkish Journal of Pediatrics 2022, 64(2):221-227.
  4. Naderian G, Parvaresh M, Rismanchiyan A, Sajadi V: Refractive errors after laser therapy for retinopathy of prematurity. Bina J Ophthalmol 2009, 15(1):13-18.
  5. Naderian, Molavi-Vardanjani, Hadipour, Sajjadi: Prevalence and Risk Factors for Retinopathy of Prematurity in Isfahan. Bina Journal of Ophthalmology 2010, 15(3):208-212.
  6. Khatami SF, YOUSEFI AE, FATEHI BGA, MAMOURI GA: Retinopathy of prematurity among 1000-2000 gram birth weight newborn infants. 2008.
  7. Fouladinejad M, Motahari MM, Gharib MH, Sheishari F, Soltani M: The prevalence, intensity and some risk factors of retinopathy of premature newborns in Taleghani Hospital, Gorgan, Iran. Journal of Gorgan University of Medical Sciences 2009, 11(2).
  8. Kazemi Rad N, Akbari Farkhani M, Abrishami M, Shoeibi N, Bakhtiari E: Incidence and risk factors of retinopathy of prematurity in Khatam Al-Anbia Ophthalmology Hospital in Mashhad City. International Journal of Scientific Research in Dental and Medical Sciences 2019, 1(3):36-39.
  9. Zarei M, Bazvand F, Ebrahimiadib N, Roohipoor R, Karkhaneh R, Farahani Dastjani A, Imani Fouladi M, Riazi Esfahani M, Khodabande A, Davoudi S Ghasemi H, Modjtahedi BS: Prevalence and Risk Factors of Retinopathy of Prematurity in Iran. J Ophthalmic Vis Res 2019, 14(3):291-298.
  10. Roohipoor R, Karkhaneh R, Farahani A, Ebrahimiadib N, Modjtahedi B, Fotouhi A, Yaseri M, Khodabande A, Zarei M, Fuladi MI: Retinopathy of prematurity screening criteria in Iran: new screening guidelines. Archives of Disease in Childhood-Fetal and Neonatal Edition 2016, 101(4):F288-F293.
  11. Nakshab M, Bayani G, Âhmadzadeh amiri A, Ëshaghi M: Prevalence of retinopathy in premature neonates in neonatal intensive care unit of Boali sina hospital in 2001. Journal of Mazandaran University of Medical Sciences 2003, 13(39):63-70.
  12. MOUSAVI SZ, RIAZI EM, Rouhipour R, JABARVAND M, Ghalichi L, NILI AM, GHASEMI F, AALAMI HZ, Karkhaneh R: Characteristics of advanced stages of retinopathy of prematurity. 2010.
  13. Khosnoud Shariati M, Fallahi M, Taslimi Taleghani N, Zonubi M, Dastijani Farahani A: Evaluation of risk factors for retinopathy of prematurity in preterm neonates. Iranian Journal of Neonatology IJN 2019, 10(1):23-30.
  14. Palizban F, Taslimi N, Shariati MK, Fallahi M, Tehranchi S, Najafiarab H: Prevalence of Preterm Births and Complications of Prematurity: A Comparison Between First Year of COVID-19 Pandemic and the Previous Year. Archives of Pediatric Infectious Diseases 2022(In Press).
  15. Karkhaneh R, Riazi Esfahani M, Ghojehzadeh L, Kadivar M, Nayeri F, Chams H, Nili Ahmadabadi M: Incidence and Risk Factors of Retinopathy of Prematurity. Bina Journal of Ophthalmology 2005, 11(1):81-90.
  16. Mousavi Z, Karkhaneh R, Riazi-Esfahani M, Mansouri M, Roohipoor R, Ghalichi L, Kadivar M, Nili-AhmadAbadi H, Naieri F: Incidence, Severity and Risk Factors for Retinopathy of Prematurity in Premature Infants with Late Retinal Examination. Bina Journal of Ophthalmology 2008, 13(4):412-417.
  17. Rasoulinejad SA, Montazeri M: Retinopathy of prematurity in neonates and its risk factors: a seven year study in northern Iran. The Open Ophthalmology Journal 2016, 10:17.
  18. Rasoulinejad SA, Ahad A: Retinopathy of prematurity progression and its related factors: A cohort study in preterm infant in northern Iran. Caspian Journal of Pediatrics 2020, 6(1):407-413.
  19. Hosseini H, Farvardin M, Attarzadeh A, Rahat F, Khalili MR, Hekmat V: Advanced retinopathy of prematurity at Poostchi ROP clinic, Shiraz. Bina J Ophthalmol 2009, 15(1):19-25.
  20. Karkhaneh R, Mousavi S-Z, Riazi-Esfahani M, Ebrahimzadeh S-A, Roohipoor R, Kadivar M, Ghalichi L, Mohammadi S-F, Mansouri M-R: Incidence and risk factors of retinopathy of prematurity in a tertiary eye hospital in Tehran. British Journal of Ophthalmology 2008, 92(11):1446-1449.
  21. Riazi-Esfahani M, Alizadeh Y, Karkhaneh R, Mansouri M, Kadivar M, Nili Ahmadabadi M, Nayeri F: Frequency and Severity of Retinopathy of Prematurity: Singleton versus Multiple-births. Bina Journal of Ophthalmology 2007, 12(4):421-427.
  22. Ebrahim M, Ahmad RS, Mohammad M: Incidence and risk factors of retinopathy of prematurity in Babol, North of Iran. Ophthalmic epidemiology 2010, 17(3):166-170.
  23. Saeidi R, Hashemzadeh A, Ahmadi S, RAHMANI S: Prevalence and predisposing factors of retinopathy of prematurity in very low-birth-weight infants discharged from NICU. 2009.
  24. Sabzehei MK, Afjeh SA, Farahani AD, Shamshiri AR: Retinopathy of prematurity: incidence, risk factors, and outcome. Archives of Iranian medicine 2013, 16(9):507.
  25. Ebrahimiadib N, Roohipour R, Karkhaneh R, Farahani A, Esfahani MR, Khodabande A, Zarei M, Taheri A, Fouladi MI, Yaseri M Modjtahedi BS: Internet-based versus Conventional Referral System for Retinopathy of Prematurity Screening in Iran. Ophthalmic Epidemiology 2016, 23(5):292-297.
  26. Mousavi SZ, Karkhaneh R, Riazi-Esfahani M, Mansouri M-R, Roohipoor R, Ghalichi L, Kadivar M, Nili-Ahmadabadi M, Naieri F: Retinopathy of prematurity in infants with late retinal examination. Journal of ophthalmic & vision research 2009, 4(1):24.
  27. Mansouri M, Kadivar M, Karkhaneh R, Riazi Esfahani M, Nili Ahmadabadi M, Faghihi H, Mirshahi A, Sadat-Nayeri F, Farahvash M, Tabatabaei A et al: Prevalence and Risk Factors of Retinopathy of Prematurity in Very Low Birth Weight or Low Gestational Age Infants. Bina Journal of Ophthalmology 2007, 12(4):428-434.
  28. Sadeghi K, Heidary E, Hashemi F, Heydarzadeh M: Incidence and Risk Factors of Retinopathy of Prematurity. Med J Tabriz Uni Med Sciences Health Services 2008, 30(2):73-77.
  29. Ahmadpour-kacho M, Zahed Pasha Y, Rasoulinejad SA, Hajiahmadi M, Pourdad P: Correlation between retinopathy of prematurity and clinical risk index for babies score. Tehran University Medical Journal 2014, 72(6):404-411.
  30. karimi yarandi H, karbasfrushan A, shokri F: Prevalence of Orthopedic pains among children and adolescents: Systematic Review and meta-analysis. Annals of Medicine and Surgery 2023.
  31. Ebrahem AM, Jameel SK, Abbas AH: Investigation of Biofilm Formation and Antibiotic Resistant of Bacteria Isolated from Septic Neonates. Journal of Medicinal and Chemical Sciences 2023, 6(4):816-826.
  32. Sadeghi SE, Malekshoar M, Vatankhah M, Adibi P, Rahmanian E, Sanie Jahromi MS, Nemati M: A Comparative Study on the Effects of Propofol and Thiopental on the Apgar score of Neonates Undergoing Cesarean Section under General Anesthesia: A Systematic Review Study. Journal of Medicinal and Chemical Sciences 2022, 5(6):1008-1017.
  33. Sharifi N, Khazaeian S, Pakzad R, Fathnezhad Kazemi A, Chehreh H: Investigating the Prevalence of Preterm Birth in Iranian Population: A Systematic Review and Meta-Analysis. J Caring Sci 2017, 6(4):371-380.
  34. Vakilian K, Ranjbaran M, Khorsandi M, Sharafkhani N, Khodadost M: Prevalence of preterm labor in Iran: A systematic review and meta-analysis. Int J Reprod Biomed 2015, 13(12):743-748.
  35. Cao G, Liu J, Liu M: Global, Regional, and National Incidence and Mortality of Neonatal Preterm Birth, 1990-2019. JAMA Pediatrics 2022, 176(8):787-796.
  36. Maroufizadeh S, Almasi-Hashiani A, Samani RO, Sepidarkish M: Prevalence of retinopathy of prematurity in Iran: a systematic review and Meta-analysis. International Journal of Ophthalmology 2017, 10(8):1273.
  37. Onyango O, Sitati S, Amolo L, Murila F, Wariua S, Nyamu G, Lango M, Patel A: Retinopathy of prematurity in Kenya: prevalence and risk factors in a hospital with advanced neonatal care. Pan African Medical Journal 2018, 29(1):1-7.
  38. Dwivedi A, Dwivedi D, Lakhtakia S, Chalisgaonkar C, Jain S: Prevalence, risk factors and pattern of severe retinopathy of prematurity in eastern Madhya Pradesh. Indian J Ophthalmol 2019, 67(6):819-823.
  39. Van der Merwe S, Freeman N, Bekker A, Smith J, Harvey J: Prevalence of and risk factors for retinopathy of prematurity in a cohort of preterm infants treated exclusively with non-invasive ventilation in the first week after birth. South African Medical Journal 2013, 103(2):96-100.
  40.