April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Small for gestational age as a risk factor for severe retinopathy of prematurity is dependent on gestational age at birth.
Author Affiliations & Notes
  • Pia Lundgren
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  • Anna Kistner
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  • Ingrid Hansen-Pupp
    Pediatrics, Lund University, Lund, Sweden
  • Gerd Holmstrom
    Ophthalmology, Uppsala University, Uppsala, Sweden
  • David Ley
    Pediatrics, Lund University, Lund, Sweden
  • Aimon Niklasson
    Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  • Lois Smith
    Boston Children Hospital, Harvard, Boston, MA
  • Carolyne Wu
    Boston Children Hospital, Harvard, Boston, MA
  • Ann Hellström
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  • Chatarina Lofqvist
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  • Footnotes
    Commercial Relationships Pia Lundgren, None; Anna Kistner, None; Ingrid Hansen-Pupp, None; Gerd Holmstrom, None; David Ley, None; Aimon Niklasson, None; Lois Smith, None; Carolyne Wu, None; Ann Hellström, None; Chatarina Lofqvist, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4580. doi:https://doi.org/
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      Pia Lundgren, Anna Kistner, Ingrid Hansen-Pupp, Gerd Holmstrom, David Ley, Aimon Niklasson, Lois Smith, Carolyne Wu, Ann Hellström, Chatarina Lofqvist; Small for gestational age as a risk factor for severe retinopathy of prematurity is dependent on gestational age at birth.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4580. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluated the impact of small for gestational age (SGA) as a risk factor for retinopathy of prematurity (ROP) requiring treatment.

 
Methods
 

In total, 2941 preterm infants born <32 weeks (wk) gestational age (GA) were eligible from five cohorts previously collected for WINROP (Weight IGF-I Neonatal ROP) analysis: Swedish (EXPRESS) (n=426), North American (n=1772), Boston (n=338), Lund (n=52), and Gothenburg (n=353). Data regarding GA, birth weight (BW), gender and ROP treatment were retrieved. Birth weight standard deviation scores (BWSDS) were calculated. SGA was defined as BWSDS less than −2.00 SDS. Risk factors; GA wk at birth, BW (50 g increments), gender, SGA and BWSDS were evaluated by both univariate and multiple logistic regression analysis.

 
Results
 

The frequency of SGA amongst infants treated for ROP increased with GA wk; of the infants treated for ROP born at GA 23 wk 4% were SGA whereas 66% of the infants treated for ROP born at GA 27 wk were SGA. In univariate analysis low GA wk at birth (p<0.001), low BW (p<0.001) and male gender (p<0.05) were significant risk factors for ROP requiring treatment, but not BWSDS nor SGA. In subgroup analysis, for infants born <26 wk GA (n=816) low GA (p<0.001) and low BW (p<0.001) were risk factors while for infants born ≥26 wk GA (n=2125) BWSDS and SGA were risk factors (p<0.001) in addition to low GA and low BW. In multiple logistic regression analysis SGA (p<0.001), male gender (p<0.01), and low GA (p<0.001) were independent risk factors for ROP requiring treatment. In subgroup analysis, for infants born <26 wk GA, SGA (OR=1.75, 95% CI 1.14-2.69, p=0.01), male gender (OR=1.53, 95% CI 1.11-2.11, p=0.01), and low GA (OR=0.48, 95% CI 0.39-0.59, p<0.001) were independent risk factors for ROP requiring treatment. For infants born ≥26 wk GA, SGA (OR=3.65, 95% CI 2.19-6.08, p<0.001) and low GA (OR=0.41, 95% CI 0.32-0.51, p<0.001) were risk factors for ROP requiring treatment for ROP.

 
Conclusions
 

SGA as a risk factor for sight threatening ROP is dependent on degree of immaturity. In the most immature infants, SGA is a less important risk factor for ROP requiring treatment than GA at birth while for the more mature infants SGA becomes a major risk factor for developing ROP requiring treatment. For instance infants born ≥26 wk GA had an almost 4 fold increased risk of ROP requiring treatment if born SGA.

  
Keywords: 706 retinopathy of prematurity • 688 retina • 698 retinal development  
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