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Is ethnicity a risk factor for severe retinopathy of prematurity?
Anil K V Aralikatti1, Arijit Mitra, Alastair K O Denniston
1Birmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham, West Midlands, UK. dr_aralikatti@hotmail.com
Insights
Ethnicity is a significant risk factor for severe retinopathy of prematurity (ROP). Asian and black infants face a higher risk of developing ROP requiring treatment compared to white infants.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in preterm infants.
- Ethnic variations in ROP incidence and severity are not well-established.
Purpose of the Study:
- To investigate the association between ethnicity and the risk of severe ROP requiring treatment.
- To determine if ethnic disparities in ROP risk persist after adjusting for key neonatal factors.
Main Methods:
- Retrospective observational study of 1690 preterm infants undergoing ROP screening over seven years.
- Statistical analysis included Kruskal-Wallis and Mann-Whitney U tests.
- Logistic regression was employed to control for birth weight and gestational age.
Main Results:
- Lower birth weight and gestational age were observed in black and Asian infants compared to white infants.
- Asian and black infants exhibited significantly higher odds of severe ROP requiring treatment (OR 2.52 and 2.51, respectively).
- These ethnic disparities remained significant even after adjusting for birth weight and gestational age.
Conclusions:
- Ethnicity is an independent risk factor for severe ROP.
- Asian and black infants have an elevated risk of developing threshold ROP compared to white infants.
- Findings highlight the need for culturally sensitive ROP screening and management strategies.
Objective:
To assess the risk of severe retinopathy of prematurity (ROP) requiring treatment in different ethnic groups.
Design:
Retrospective observational study on ROP screening and treatment. It involved a cross-sectional review of all eligible infants over a seven-year period. Statistical tests used were the Kruskal-Wallis test and Mann-Whitney U test. Logistic regression was used to control for any differences in birth weight and gestational age.
Setting:
City Hospital and Birmingham Women's Hospital, Birmingham, UK.
Results:
1690 preterm infants underwent ROP screening. Birth weight was lower in black (1142.5 g) and Asian infants (1180 g) when compared to white infants (1196.5 g). Gestational age was lower in black infants (28.5 weeks) compared to Asian and white infants (both 29 weeks). Compared to white infants, the odds of severe ROP requiring treatment was higher in Asian infants (odds ratio (OR): 2.52; 95% CI 1.41 to 4.50) and black infants (OR: 2.51; 95% CI 1.30 to 4.86). The additional risk from ethnicity was present even after adjusting for birth weight and gestational age (adjusted OR for Asian vs white infants: 2.45; 95% CI 1.334 to 4.497); (adjusted OR for black vs white infants: 2.0; 95% CI 1.004 to 4.014).
Conclusions:
Ethnicity is a risk factor for severe ROP. Asian and black infants have a higher risk of developing threshold ROP compared to white infants.
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