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Published on: January 7, 2018
Association of Intrauterine Growth with Retinopathy of Prematurity Risk in Very Preterm Infants: A Multicenter Cohort
Juan Du1,2, Xinyue Gu3, Siyuan Jiang3,4
1Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Insights
Lower birth weight percentile in premature infants is linked to higher retinopathy of prematurity (ROP) risk. A 10% decrease in birth weight percentile increases ROP odds by 15%.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Intrauterine growth status, measured by birth weight (BW) percentiles, has an unclear impact on retinopathy of prematurity (ROP) development.
- Establishing BW percentile-specific risk gradients is crucial for understanding ROP pathogenesis.
Purpose of the Study:
- To determine the relationship between BW percentile and ROP incidence in preterm infants.
- To establish BW percentile-specific risk gradients for ROP development.
Main Methods:
- A multicenter cohort study analyzed data from the Chinese Neonatal Network (2019-2021).
- Exposure: Gestational age (GA)- and sex-specific BW percentile. Outcome: ROP incidence.
- Adjusted odds ratios (ORs) were calculated, stratified by GA, infant sex, maternal hypertension, and birth status.
Main Results:
- 17,882 preterm infants were included; mean BW 1300g, GA 29.9 weeks.
- ROP incidence was 27% (any stage) and 3.7% (severe ROP, stage ≥3).
- Each 10% decrease in BW percentile increased ROP odds by 15% (aOR 0.85). Optimal cut-offs were 26% for any ROP and 19% for severe ROP.
Conclusions:
- ROP incidence is negatively associated with BW percentile in preterm infants.
- Lower BW percentiles (<26% for any ROP, <19% for severe ROP) significantly elevate ROP risk.
- These findings highlight the importance of monitoring BW percentiles for ROP risk assessment.
Introduction:
The impact of intrauterine growth status as measured by BW percentiles on retinopathy of prematurity (ROP) pathogenesis remains inadequately characterized. The objectives of the study were to establish BW percentile-specific risk gradients for ROP development.
Methods:
A multicenter cohort study was conducted with data were collected from Chinese Neonatal Network between January, 2019 and December, 2021. The exposure was GA- and sex-specific BW percentile. The primary outcome was incidence of ROP. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, adjusted for potential confounders, and stratified by GA, infant sex, maternal hypertension, singleton/multiple birth.
Results:
Totally 17,882 preterm infants were enrolled, BW was 1,300.0 (1,100.0-1,500.0) g and GA was 29.9 (28.6-31.0) weeks. The incidence was 27% for any stage ROP and 3.7% for severe ROP (stage 3 or above). Each decrease of BW percentile by 10% was associated with 15% increase of odds for either any stage ROP (aOR 0.85 [95% CI: 0.83-0.86]) or severe ROP (aOR 0.85 [95% CI: 0.82-0.89]). The optimal discriminative BW percentile on receiver operating characteristic curve was 26% for predicting any stage ROP and 19% for predicting severe ROP. Lower BW percentile under these cut-offs were associated with elevated odds of any stage ROP (aOR 2.20 [95% CI: 1.97-2.47] and severe ROP (aOR 2.91 [95% CI: 2.22-3.80]).
Conclusions:
ROP incidence was negatively associated with BW percentile. Each 10% decreased BW percentile was associated with 15% increased odds of any stage ROP and severe ROP.
