Abstract
Purpose :
The etiology for optic nerve hypoplasia (ONH), a leading cause of congenital visual impairment, remains unknown. Previous research implicated primiparity, young maternal age, inadequate weight gain and vaginal bleeding based on self-reported questionnaire data. We sought to validate these suggested correlates using clinical documentation from prenatal medical records.
Methods :
We analyzed prenatal medical records of 49 mother-child pairs enrolled in a prospective research registry at the Children’s Hospital Los Angeles. Complete weight data for the duration of prenatal care was available for 40 cases. Prenatal records were incomplete for 8 cases due to transfer of prenatal care (n=4), lost to follow up (n=3), or weight exceeding scale (n=1). Maternal weights, obstetric history, substance use, and other prenatal complications including vaginal bleeding and preterm labor were obtained from medical records. Maternal weight data were compared to 2009 Institute of Medicine (IOM) guidelines.
Results :
Median maternal age at birth was 23.3 years (IQR 21.4, 27.2). Primiparity was reported in 67.4% (33/49). A prior pregnancy resulting in spontaneous or elective abortion was reported in 30.6% (15/49). Of the mothers with a prior pregnancy, an interpregnancy interval of one year or less was reported in 36% (9/25). Gestational vaginal bleeding occurred in 35.7% (10/28), half occurring in the 1st trimester. Stratified analysis of overall weight gain by pre-pregnancy BMI showed 40% (12/30) of mothers gained below IOM guidelines; 46.4% (13/28) lost or did not gain weight during the 1st trimester. Inadequate weight gain was more common in mothers under age 25 yrs. compared to those aged 25 yrs. or older (42% vs 10%, p=0.07). Median gestational age was 39.9 weeks (IQR 38.7, 40.9) and median birthweight was 7.2 lbs. (IQR 6.2, 8.1). 55% (27/49) had complications including: elevated AFP (n=3), intrauterine growth restriction (n=5), prior ectopic pregnancy (n=2), prior gynecologic surgery: salpingectomy, bladder fistula repair, cervical scarring due to multiple dilation and curettage (n=5), chorioamnionitis (n=4), uterine artery notching (n=2), and placental meconium staining (4).
Conclusions :
Young maternal age and primiparity persisted as prenatal correlates in this cohort. Clinical documentation confirms a high prevalence of inadequate weight gain and vaginal bleeding, greater than in the general population.
This is a 2020 ARVO Annual Meeting abstract.