Barriers to screening infants for retinopathy of prematurity after discharge or transfer from a neonatal intensive care unit.

Objective: To assess neonatal intensive care unit (NICU) practices affecting screening and follow-up for retinopathy of prematurity (ROP).

Methods: Retrospective study of infants at risk for ROP, eligible for back transport, admitted to a regional NICU from January 1, 1999 until May 31, 2002. Patients failed to receive needed follow-up for ROP after discharge or transfer from a NICU, if we could not verify their ROP screening follow-up within 1 month.

Results: A total of 74 infants were identified to need follow-up eye care. Infants who did not receive the follow-up care had greater mean gestational age (mean SD; 30.7+/-2.3 vs 29.6+/-2.5 weeks, p=0.05) and birth weights (mean SD; 1581+/-366 vs 1360+/-508 g, p=0.007), compared to infants who received the recommended care. Infants transported back to the community hospital were significantly more likely to miss follow-up eye care compared to infants discharged from the regional center (relative risk 2.81, 95% confidence interval (CI) (1.09 to 7.20)). Infants not screened for ROP in the NICU had greater risk for missing follow-up care compared to infants who had their first retinal examination in the NICU (relative risk 4.25, 95% CI (1.42 to 12.73)).

Conclusions: Infants transferred back or discharged from the NICU before ROP screening represent a high-risk group for not receiving follow-up eye care.