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Risk of long-term ophthalmological complications in Taiwanese preterm infants: a nationwide cohort study
Chia-Yu Huang1,2, Sio-Ian Tou3, Heng-Jun Lin4,5
1Department of Family Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
Insights
Preterm birth and low birth weight significantly increase the risk of long-term eye complications in infants. Combining these factors further elevates the risk, necessitating targeted follow-up care.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Preterm infants face higher risks of various health issues.
- Ophthalmological complications are a significant concern in neonatal care.
- Understanding risk factors for long-term eye conditions in preterm infants is crucial.
Purpose of the Study:
- To investigate the association between maturity levels, birth weights, and long-term ophthalmological complications in preterm infants.
- To quantify the increased risk of eye conditions in preterm infants based on birth characteristics.
Main Methods:
- A nationwide, population-based cohort study.
- Inclusion of over 735,000 newborns born between 2009-2012.
- Exclusion of infants with congenital deformities, missing data, or those who died before age 8.
- Categorization into full-term, preterm without retinopathy of prematurity (ROP), and preterm with ROP cohorts.
Main Results:
- Preterm infants, with or without ROP, showed elevated risks of ophthalmic complications (aORs 1.48-10.34).
- Extremely low birth weight was associated with a significantly increased risk of eye complications (aORs 2.21-6.55).
- The presence of multiple risk factors, like prematurity and low birth weight, compounded the risk (aORs 1.03-23.86).
Conclusions:
- Infant immaturity and low body weight are identified risk factors for ophthalmological complications.
- The combined presence of prematurity and low birth weight substantially increases the risk of eye complications.
- Findings underscore the need for comprehensive follow-up plans for preterm infants, informing caregivers and policymakers.
Objectives:
The aim was to determine whether different maturity levels and birth weights could change the risk of long-term ophthalmological complications in preterm infants.
Design:
This was a cohort study.
Setting:
This was a nationwide population-based study.
Participants:
Newborns born between 2009 and 2012 were identified; newborns with congenital deformities, newborns with missing data on urban area, sex, gestational week at birth or birth weight and newborns who died before the age of 8 years were excluded.
Interventions:
Infants were divided into full-term, preterm and preterm with retinopathy of prematurity (ROP) cohorts based on their basic characteristics at birth.
Primary Outcome Measures:
The primary outcomes were ophthalmological complications, including strabismus, refractive error, amblyopia, cataracts and glaucoma.
Results:
Ultimately, 735 702 infants were included in the analysis. There were 727 403, 7165 and 1134 newborns in the full term, preterm without ROP and preterm with ROP cohorts, respectively. Premature infants, whether without ROP or with ROP, had an elevated risk of various ophthalmic complications, with adjusted ORs (aORs) ranging from 1.48 to 2.74 and 1.90 to 10.34, respectively. Extremely low birth weight contributes to an increased risk of various ophthalmic complications, with aORs ranging from 2.21 to 6.55. Moreover, a higher number of negative variables, such as preterm birth or low body weight, increased the risk of various ophthalmological complications, with the aOR falling within the range of 1.03-23.86.
Conclusions:
Immaturity and low body weight were risk factors for ophthalmological complications in preterm infants. The presence of both of these two risk factors increased the risk of ophthalmological complications. Our results are essential for caregivers and health policy-makers to design comprehensive follow-up plans for preterm infants.
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