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R. K. Wong, Y. Yonekawa, G. Sun, M. M. DeAngelis, M. Morrison, M. F. Chiang, T. C. Lee, R. V. P. Chan; Update: Assisted Conception and Progression of Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3143.
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Retinopathy of prematurity (ROP) is a leading cause of blindness in children. Assisted conception is associated with ROP’s major risk factors, low birth weight (BW) and low gestational age (GA). However, the direct impact of assisted conception on ROP development is not well established. Previous preliminary data from our group has suggested that assisted conception may be associated with treatment-requiring ROP in non-black infants < 1500 g. The aim of the current study was to investigate the role of assisted conception on the progression of earlier stages of ROP.
We performed a retrospective review of consecutive non-black inborn patients screened for ROP (GA ≤ 32 weeks and/or BW < 1500 g) in the neonatal intensive care unit of the New York-Presbyterian Hospital_Cornell from June 2002 to August 2008. Patients were divided into natural or assisted conception.
Our study included 352 infants, of whom 137 were born through assisted conception and 215 through natural conception with mean BW’s of 1260.5 g and 1197.1 g, respectively. GA, oxygen exposure, and treatment criteria were comparable between both groups. Using single variable analyses, we did not observe strong data to suggest that assisted conception placed infants at greater risk for the development of stage 0 [odds ratio (OR) 1.3; 95% confidence interval (CI) 0.8-2.2], stage 1 (OR 0.8; 95% CI 0.5-1.3), stage 2 (OR 0.8; 95% CI 0.4-1.4), or stage 3 ROP (OR 0.9; 95% CI 0.5-1.8).However, using multivariate analysis, we did observe a statistically significant trend that assisted conception placed infants at greater risk for treatment-requiring ROP [OR 4.5; 95% CI 1.3-15.5; p=0.0150].
Infants born via assisted conception may progress through the early stages of ROP similarly to their naturally conceived counterparts; however, once they develop stage 3 disease they may be at higher risk for treatment-requiring ROP.
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