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Racial Differences in Retinopathy of Prematurity
Jingyun Wang1, Gui-Shuang Ying2, Yinxi Yu2
1Department of Biological and Vision Science, State University of New York College of Optometry, New York, USA.
Insights
Black preterm infants experienced lower rates of retinopathy of prematurity (ROP) and plus disease, despite having lower birth weights and gestational ages. Further research is needed to understand these racial differences in ROP incidence.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Epidemiology
- Racial Health Disparities
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Racial and ethnic variations in ROP incidence and severity have been observed but require further investigation.
- Understanding these disparities is crucial for targeted interventions and improved outcomes.
Purpose of the Study:
- To analyze racial differences in the incidence and progression of ROP among premature infants.
- To compare ROP severity, disease progression, and postnatal weight gain across different racial groups.
- To identify potential factors contributing to observed racial variations in ROP.
Main Methods:
- Secondary analysis of data from the Postnatal Growth and ROP Studies (G-ROP-1 and G-ROP-2) involving 41 North American hospitals (2006-2017).
- Premature infants categorized into White, Black, and Asian groups based on maternal race.
- Comparison of ROP incidence, severity, time course, plus disease, and postnatal weight gain rates across racial groups, adjusting for birth weight (BW) and gestational age (GA).
Main Results:
- Black infants had significantly lower BW and GA compared to White and Asian infants.
- Incidences of severe ROP, ROP, and plus disease were lower in Black infants, even after adjusting for BW and GA (RR: 0.69, 0.83, 0.44 respectively).
- Postnatal weight gain rates were similar during early postnatal days but lower in Black and Asian infants later; no racial differences in ROP timing were observed.
Conclusions:
- Black preterm infants exhibit lower incidences of ROP and plus disease compared to White infants, despite lower BW and GA.
- The underlying biological or environmental mechanisms driving these racial disparities in ROP require further investigation.
- These findings highlight the complexity of ROP development and the need for continued research into racial variations.
Purpose:
To delineate racial differences in the incidence and time course of ROP in a large cohort of premature infants.
Methods:
The secondary analysis of data from the two Postnatal Growth and ROP Studies (G-ROP-1 and G-ROP-2) that were collected in 41 hospitals in North America from 2006 to 2017. According to self-reported maternal race, premature infants were classified into 3 groups: White (N = 5580), Black (N = 3252), and Asian (N = 353). Incidence, severity, and time course of ROP; plus disease; and postnatal weight gain rate were compared among racial groups.
Results:
Black infants had significantly smaller BW (mean 1035 vs. 1131 vs.1144 grams, P < .001) and lower GA (28.2 vs. 28.6, vs. 29.1 weeks, P < .001) than White and Asian infants. However, Black infants had lower incidences of severe ROP (11.1% vs. 12.4% vs. 11.9%), ROP (42.1% vs. 43.2% vs. 30.6%), and plus disease (3.6% vs. 6.3%, vs. 5.9%) than White and Asian infants (BW and GA adjusted risk ratio for Black vs. White 0.69 for severe ROP, 0.83 for ROP, 0.44 for plus disease, all P < .0001). Mean daily-weight-gain on days of life 11-20 and 21-30 were similar across groups (P > .05), but lower in Black and Asian infants on days 31-40 (P < .001). There were no differences in the timing of severe ROP and ROP across racial groups.
Conclusions:
Despite relatively lower GA, BW, and daily-weight-gain, Black preterm infants had lower incidences of ROP and plus disease than White preterm infants. The mechanisms for these differences require further investigation.
