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Published on: October 24, 2019
Antecedents and correlates of visual field deficits in children born extremely preterm
Mari Holm1, Michael E Msall2, Jon Skranes3
1Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, N-7489 Trondheim, Norway; Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111, USA.
Insights
Visual field deficits (VFDs) in extremely preterm infants are linked to various factors, including maternal aspirin use and early postnatal complications like acidemia and respiratory support. These findings highlight a multifactorial cause for visual impairments in premature infants.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Developmental pediatrics
Background:
- Visual field deficits (VFDs) are a significant concern in infants born extremely preterm.
- Understanding the factors contributing to VFDs is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To identify antecedents and correlates of VFDs at age 2 years in infants born before 28 weeks of gestation.
- To elucidate the complex etiology of visual impairments in extremely preterm infants.
Main Methods:
- Confrontation visual field assessment at age 2 years in 1023 infants.
- Comparison of antenatal and postnatal characteristics between infants with and without VFDs.
- Time-oriented logistic regression models to assess risk factors for VFDs.
Main Results:
- VFDs were associated with maternal aspirin use, early postnatal acidemia, cerebral ventriculomegaly, prethreshold retinopathy of prematurity (ROP), and prolonged oxygen/ventilator dependence.
- Birth before 27 weeks gestation increased risk, but this was attenuated by postnatal factors.
Conclusions:
- Both antenatal and early/late postnatal factors are associated with an increased risk of VFDs in extremely preterm infants.
- The study supports a multifactorial etiology for visual deficits in prematurity.
- Findings contribute to a better understanding of the complex causes of visual impairment in this vulnerable population.
Aim:
We sought to identify the antecedents and correlates of visual field deficits (VFDs) at age 2 years among infants born before the 28th week of gestation.
Methods:
The visual fields of 1023 infants were assessed by confrontation at age 2 years. We compared the ante-and postnatal characteristics and exposures of the 65 infants with a VFD to their peers who did not have a VFD. We used time-oriented logistic regression risk models to assess the associations of potential antecedents and correlates with a VFD.
Results:
In the final regression model, VFD was associated with maternal consumption of aspirin during the current pregnancy, recurring/persistent acidemia during the first 3 postnatal days, cerebral ventriculomegaly seen on neonatal ultrasound, prethreshold retinopathy of prematurity (ROP), and supplemental oxygen and ventilator dependence at 36 weeks post-menstrual age. Birth before the 27th week was also associated with increased risk, but its significance was diminished by the addition of postnatal variables.
Conclusion:
In this sample of extremely preterm born infants, antenatal as well as early and late postnatal characteristics and exposures are associated with an increased risk of having a VFD. Our study adds to our knowledge about the complex etiology of visual deficits of prematurity, and supports a multifactorial cause of these deficits.
