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Retinopathy of prematurity: risk stratification by gestational age

Journal of Perinatology volume 43, pages 694–701 (2023)Cite this article

Subjects

Abstract

Objective

To identify gestational age (GA) specific risk factors for severe ROP (sROP).

Study design

Single-center cohort stratified by GA into <24 weeks, 24–26 weeks and ≥27 weeks.

Results

132/1106 (11.9%) developed sROP. Time to full feeds was the only risk factor [HR 1.003 (1.001–1.006), p = 0.04] for infants<24 weeks GA. For infants 24–26 weeks GA, a higher GA was protective [HR 0.66 (0.51–0.85), p < 0.01], whereas steroids for bronchopulmonary dysplasia (BPD) [HR 2.21 (1.28–3.26), p < 0.01], patent ductus arteriosus (PDA) ligation [HR 1.99 (1.25–3.11), p < 0.01] and use of nitric oxide [HR 1.96 (1.11–3.30), p = 0.01] increased the hazard of sROP. Increasing birthweight was protective [HR 0.70 (0.54–0.89), p < 0.01] in infants ≥27 weeks GA. Cumulative hazard of sROP reached 1.0 by fifteen weeks for <24 weeks GA, 0.4 by twenty weeks for 24–26 weeks GA, and 0.05 by twenty weeks after birth for ≥27 weeks GA.

Conclusions

Risk factors, cumulative hazard, and time to sROP vary by GA.

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Fig. 1: Cumulative hazard rate of sROP, risk stratified by gestational age. Lines represent GA vs. full cohort.

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Data availability

Sharing of local data generated for this study is subject to rules per institutional review board.

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Acknowledgements

We would like to thank data coordinators Amy Distler, RN and Gina Myers, RN for their help in data collection, and Dr Neeta Vachharajani for statistical support.

Funding

None This research was supported by an unrestricted grant from Research to Prevent Blindness (MR).

Author information

Authors and Affiliations

  1. Division of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Tiffany Wu

  2. Associate Professor of Pediatrics, Washington University in St Louis, St. Louis, MO, USA

    Rakesh Rao

  3. Division of Biostatistics, Washington University in St Louis, St. Louis, MO, USA

    Hongjie Gu

  4. Department of Ophthalmology and Visual Sciences, Washington University in St Louis, St. Louis, MO, USA

    Andrew Lee & Margaret Reynolds

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Contributions

Drs. Reynolds, Rao and Ms. GU had full access to all data in the study and take full responsibility for the integrity of the data and the accuracy of the analyses. Concept and design: TW, RR, HG, MR, AL Data acquisition, analyses and interpretation; TW, HG, RR, MR Drafting of manuscript: HW, MR, RR Critical revision of manuscript: HW, MR, RR, AL, HG Statistical analyses: HG, RR, MR Supervision: MR, RR All authors were involved in reviewing, revising and approving the final manuscript for submission.

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Correspondence to Rakesh Rao.

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Wu, T., Rao, R., Gu, H. et al. Retinopathy of prematurity: risk stratification by gestational age. J Perinatol 43, 694–701 (2023). https://doi.org/10.1038/s41372-023-01604-9

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