Related Experiment Video
Updated: Apr 24, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Prethreshold retinopathy in premature infants with intrauterine growth restriction
Jennifer W Lee1, Deborah VanderVeen, Elizabeth N Allred
1Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.
Insights
Very preterm newborns with severe growth restriction face a higher risk of retinopathy of prematurity (ROP). This study highlights the importance of gestational age and growth status in predicting ROP risk.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Previous studies on ROP risk factors have yielded conflicting results, potentially due to differing infant selection criteria.
- The interplay between gestational age, birth weight, and ROP risk requires further clarification.
Purpose of the Study:
- To investigate the association between growth restriction and the risk of developing prethreshold ROP in very preterm infants.
- To examine whether birth weight-based sampling in prior research may have confounded the relationship between gestational age and ROP.
- To identify key risk factors for ROP in a well-defined cohort of extremely preterm infants.
Main Methods:
- Utilized data from the ELGAN Study, a large cohort of extremely preterm infants.
- Employed logistic regression models to assess the risk of prethreshold ROP, adjusting for potential confounders.
- Calculated odds ratios (OR) and 99% confidence intervals to quantify risk.
- Generated scatter plots to visualize the relationship between gestational age and birth weight in different study populations.
Main Results:
- Low gestational age (23-24 weeks and 25-26 weeks) was significantly associated with an increased risk of prethreshold ROP.
- Severe intrauterine growth restriction (birth weight Z-score <-2) was also a strong predictor of increased prethreshold ROP risk.
- Analysis revealed that studies sampling based on birth weight tend to overrepresent older, severely growth-restricted infants.
Conclusions:
- Both extremely low gestational age and severe intrauterine growth restriction are independent risk factors for developing prethreshold ROP in very preterm infants.
- Gestational age and growth status are critical determinants of ROP risk that must be considered in research and clinical practice.
- Findings underscore the need for careful consideration of infant selection criteria in studies examining ROP etiology.
Aim:
To determine, among very preterm newborns, whether those who are growth-restricted are at increased risk of retinopathy of prematurity (ROP), and to explore whether the mixed findings of prior studies are the consequence of sampling based upon birthweight instead of gestational age.
Methods:
Using data from the ELGAN Study, we created logistic regression models of prethreshold ROP risk to adjust for confounders and calculate odds ratios and 99% confidence intervals. We created scatter plots to display the gestational age/birthweight relationship in infants enrolled in studies with different selection criteria.
Results:
Low gestational age [23-24 weeks, OR 11.6 (2.9, 47); 25-26 weeks, 8.1 (2.1, 32)] and severe growth restriction [birthweight Z-score <-2, OR 9.1 (1.1, 76)] were associated with increased risk of prethreshold ROP. We documented in scatter plots that a sample defined by birthweight has an excess of gestationally older, severely growth-restricted newborns.
Conclusion:
In this sample, low gestational age and severe growth restriction were associated with increased risk of prethreshold ROP.
