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Retinopathy of prematurity: a new epidemic?
D L Gibson1, S B Sheps, M T Schechter
1Department of Health Care, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Insights
A new epidemic of retinopathy of prematurity-induced blindness is identified, particularly affecting premature infants. This study provides the first population-level evidence of this concerning trend.
Area of Science:
- Ophthalmology
- Public Health
- Neonatology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Previous ROP epidemics have been linked to intensive neonatal care practices.
- The emergence of a new ROP epidemic has been suspected but lacked population-level evidence.
Purpose of the Study:
- To provide the first empiric evidence for a new epidemic of retinopathy of prematurity-induced blindness.
- To determine the incidence of ROP-induced blindness in British Columbia from 1952 to 1983.
- To analyze changes in ROP-induced blindness incidence over time and by birth weight.
Main Methods:
- Utilized a population-based register of handicapping conditions in British Columbia.
- Employed a birth weight-specific census of live-born infants in British Columbia.
- Conducted standardized incidence ratio analyses on data from 1952 to 1983, divided into two periods (1955–1964 and 1965–1983).
Main Results:
- A marginally significant increase in the overall incidence of ROP-induced blindness was observed in the later period (1965–1983) compared to the earlier period (1955–1964).
- Infants weighing 750 to 999 g at birth showed a significantly increased standardized incidence ratio of 3.07.
- No increased risk was found in infants lighter or heavier than this specific birth weight range.
Conclusions:
- The findings provide the first population-level evidence supporting a new epidemic of retinopathy of prematurity-induced blindness.
- The increased incidence is specifically linked to premature infants weighing 750 to 999 g at birth.
- Changes in ascertainment or diagnostic practices do not explain the observed weight-specific increases in incidence.
Abstract:
This study provides the first empiric evidence for the existence of a new epidemic of retinopathy of prematurity-induced blindness. Data from a population-based register of handicapping conditions in the Canadian province of British Columbia, and a birth weight-specific census of live-born infants in British Columbia, were used to determine annual, population-level incidences of retinopathy of prematurity-induced blindness during 1952 to 1983. Changes in incidence since the end of the original epidemic (1954) were determined by subdividing the 29-year period (1955 to 1983) into two intervals (1955 to 1964 and 1965 to 1983). Standardized incidence ratio analyses revealed a marginally significant increase in the overall incidence of retinopathy of prematurity-induced blindness in the later as compared with the earlier period. Infants weighing 750 to 999 g at birth had a significantly increased standardized incidence ratio of 3.07 (95% confidence interval 1.26, 11.06). No increases in risk were observed in heavier or lighter weight infants. Because ascertainment and diagnostic changes do not explain the weight-specific increases in incidence, these results provide the first population-level evidence for a new epidemic.