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Risk of Retinopathy of Prematurity in Preterm Births with Respiratory Distress Syndrome: A Population-Based Cohort
Ya-Wen Lin1, San-Ni Chen2, Chih-Hsin Muo3
1School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan.
Insights
Infants born prematurely with respiratory distress syndrome (RDS) face a higher risk of retinopathy of prematurity (ROP). This risk is elevated even for those not born with low birth weight, highlighting RDS as a key factor.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Public Health
Background:
- Respiratory distress syndrome (RDS) is a significant risk factor for retinopathy of prematurity (ROP) in preterm infants.
- Investigated the association between RDS and ROP incidence using population-based infant data.
Purpose of the Study:
- To evaluate if respiratory distress syndrome (RDS) is associated with an increased incidence of retinopathy of prematurity (ROP) in preterm infants.
Main Methods:
- Utilized Taiwan's National Health Insurance claims data (2000-2009).
- Established a cohort of 7,573 preterm infants with RDS and 11,428 without RDS.
- Followed infants for one year to identify incident ROP and calculated hazard ratios (HR) with 95% confidence intervals (CI).
Main Results:
- ROP incidence was 2.5-fold higher in infants with RDS (30.3 per 100 person-years) compared to controls (11.9 per 100 person-years), with an adjusted HR of 1.28.
- Factors associated with increased ROP incidence included low birth weight, extended NICU stay, female gender, and RDS.
- The adjusted HR for ROP in RDS infants was highest for those with normal birth weight (3.33) and increased with invasive ventilation or NICU stay ≥30 days.
Conclusions:
- Preterm infants diagnosed with respiratory distress syndrome (RDS) exhibit an elevated risk of developing retinopathy of prematurity (ROP).
- This heightened risk is not confined solely to infants with low birth weights, underscoring the impact of RDS across different birth weight categories.
Background:
Respiratory distress syndrome (RDS) is a risk factor that plays an important role in retinopathy in preterm infants. We used population data of infants to investigate this relationship. This study evaluated whether respiratory distress syndrome was associated with an increased incidence of ROP in preterm infants.
Methods:
From the National Health Insurance claims data of Taiwan in the 2000-2009 period, preterm infants were identified to establish a RDS cohort (N = 7573) and a comparison cohort without RDS (N = 11428). We followed each infant for one year to identify incident retinopathy of prematurity (ROP) for comparison between the two cohorts. The RDS cohort for comparisons of hazard ratio (HR) with 95% confidence interval (CI) were calculated.
Results:
Low birth weight, an extended stay in the neonatal intensive care unit (NICU), female gender, and RDS were factors associated with an increased incidence of ROP. The ROP incidence was 2.5-fold higher in RDS children than in control (30.3 versus 11.9 per 100 person-years), with an adjusted HR (aHR) of 1.28 (95% CI = 1.18-1.39). The incidence increased as the birth weight decreased in both cohorts, but the RDS cohort to the comparison cohort aHR decreased as the birth weight decreased, not significant for groups with birth weights less than 1500g. The aHR for RDS children was the highest for infants with a normal birth weight: 3.33 (95% CI = 2.09-5.31). Among infants with RDS, the ROP incidence increased to 51.0 per 100 person-years in those who underwent invasive ventilation, or to 76.3 per 100 person-years for NICU stay for ≥30 days.
Conclusion:
Preterm infants with RDS are at an elevated risk of developing ROP, not limited to those with low birth weights.
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