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Published on: December 31, 2015
Long-term refractive status of preterm infants from singleton and multiple pregnancies
N Levy1,2, E S Shinwell3,4, H Leiba1,2
1a The Hebrew University , Jerusalem , Israel.
Insights
Multiple birth in preterm infants increases the risk of refractive errors, especially myopia, by age 8-12 years. Preterm children generally experience a shift from hyperopia to myopia during childhood.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Genetics
Background:
- Preterm birth is a significant risk factor for various health issues, including visual impairments.
- Refractive status in early childhood can predict long-term visual outcomes.
- Multiple gestation is associated with increased risks in preterm infants.
Purpose of the Study:
- To investigate the impact of multiple gestation on refractive status in former preterm infants.
- To compare refractive errors in singleton and multiple births among very low birth weight (VLBW) infants.
- To identify predictors of refractive status at 8-12 years in preterm children.
Main Methods:
- Longitudinal study comparing refraction in singleton and multiple VLBW infants at 6 months and 8-12 years.
- Comparison of preterm infants with term-born controls.
- Statistical analysis to identify predictors of refractive errors.
Main Results:
- Multiple births showed significantly higher rates of refractive errors (54%) compared to singletons (28%) at 8-12 years, particularly myopia.
- Preterm infants had more refractive errors (37%) than term-born children (14%).
- Refractive status at 6 months and multiple birth status predicted later refractive errors, while birth weight and retinopathy of prematurity did not.
Conclusions:
- Multiple gestation in preterm infants is linked to an elevated risk of childhood refractive errors, predominantly myopia.
- Refractive development in preterm children progresses from hyperopia in infancy to myopia by school age.
- Former preterm infants exhibit a higher prevalence of refractive errors compared to their term-born peers.
Objective:
To study the effect of plurality on refractive status in former preterm infants at age 8-12 years.
Methods:
Refraction was compared in singletons and multiples, in very low birth weight infants (VLBW, <1500 g) at age 6 months and 8-12 years. Preterm infants were compared with a group of term infants.
Results:
Thirty-seven of 104 (36%) VLBW infants were multiples. Comparison of refraction between singletons and multiples revealed no difference at age 6 months, while at age 8-12 years, multiples had significantly more refractive errors (singletons 28% versus multiples 54% p = 0.01), particularly myopia. In preterms, refractive status at age 6 months and multiple birth were significant predictors of refraction at 8-12 years, while birth weight (BW) and retinopathy of prematurity (ROP) were not predictive. Refractive errors were significantly more common in preterms (37%) than in term-born children (14%) (p = 0.0002). Overall, refraction moved from predominantly hyperopic at 6 months to normal or myopic at age 8-12 years in preterm.
Conclusions:
Multiple gestation in preterms is associated with increased risk for refractive errors, particularly myopia in childhood. Refraction in preterms during childhood progresses from hyperopia to myopia. Former preterms have more refractive errors than children born at term-born children.
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