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Y. Yonekawa, G. Sun, M. Weissman, J. M. Perlman, H. Shin, M. F. Chiang, T. C. Lee, R. V. P. Chan; The Association Between Assisted Conception and Progression of Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1400.
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Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the developing retina that continues to be a major cause of blindness in children. Known risk factors include low birthweight (BW), low gestational age (GA), and prolonged oxygen exposure. Although assisted conception has been associated with low BW and GA, its impact on the development and progression of ROP has not been well established. We aim to investigate if assisted conception is a risk factor for advanced ROP requiring treatment.
We conducted a retrospective chart review of consecutive inborn patients admitted to the New York-Presbyterian Hospital, Weill Cornell Medical Center (WCMC) neonatal intensive care unit from June 2002 to August 2007. Patients included all non-black infants screened for ROP based on screening criteria of GA less than or equal to 32 weeks and/or BW<1500 g. Patients were divided into natural or assisted conception, and stratified into <750 g, 750-1499 g, and greater than or equal to 1500 g. Excluded were all patients not born at WCMC, those patients who had preexisting congenital disorders, lacked appropriate follow-up, or expired.
Our study included 317 infants, of whom 187 were conceived naturally and 130 were born through assisted conception, with mean BW of 1202.7 g and 1268.9 g, respectively. GA, oxygen exposure, and treatment criteria were comparable between both groups. Six (3.2%) natural conception patients and 10 (7.7%) assisted conception patients required laser treatment. We observed a trend that assisted conception placed infants at greater risk for ROP requiring treatment (odds ratio [OR] 2.5; 95% confidence interval [CI], 0.9 to 7.1). Risk was highest for infants <750 g (OR 5.3; 95% CI, 0.9 to 30.6). No infant greater than or equal to 1500g required treatment. Mean GA at which treatment was required was higher for assisted conception patients than in natural conception patients (35.8 vs 34.0 weeks, respectively; P<0.05).
Assisted conception may be associated with ROP requiring treatment in non-black infants <1500 g. In our study, infants born through assisted conception required treatment later than those conceived naturally.
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