Intrauterine Growth Restriction (IUGR) as a Risk Factor for Retinopathy of Prematurity (ROP) Severity in a Population of Black Infants

Abstract

Purpose : Although the two major risk factors for the development of retinopathy of prematurity (ROP) are premature birth and low birth weight, there is a question as to whether intrauterine growth restriction (IUGR) may be an important risk factor for ROP. A previous study that investigated this relationship found no correlation, however the study population consisted of only non-Black subjects. This retrospective cohort study aims to further explore whether IUGR impacts the development of ROP and its severity in a subset of Black infants to see how the inclusion of these demographics impact any correlation that may exist.

Methods : This is a single center retrospective chart review of all infants admitted to the UI Hospital and Health System NICU between 1/1/2010 and 1/1/2020 with a birth weight less than or equal to 1500g who had a pupillary dilation event. Infants were excluded if they died or were transferred before an ROP exam or had missing data in the chart. IUGR was defined as less than the 10th percentile for gestational age using the Fenton growth chart. Statistical analyses included single variable analysis, Spearman correlation and cumulative logistic regression analysis for predicting ROP stage from IUGR, Black ancestral background, and the interaction of these two parameters.

Results : The study population consisted of 518 infants, with 341 (66%) Black infants. In this subset of Black infants, 47 (14%) had IUGR and 149 (44%) were diagnosed with ROP. Within the Black population, IUGR vs. non-IUGR did not significantly impact the risk of an ROP diagnosis (0.56 OR, 95% CI 0.029 – 1.08, P=0.08) or the stage of ROP should it exist (Spearman Rho= 0.16, P=0.05). In contrast, within the subset of all infants with IUGR, we found a significant association between IUGR and ROP stage between Black and non-Black patients (P=0.01). Black infants with IUGR and ROP are more likely to have a more severe stage of ROP than their non-Black counterparts.

Conclusions : Our results illustrate that although IUGR is not a significant risk factor for ROP in Black infants, those that do develop ROP are at a higher risk for more severe disease compared to non-Black infants. Further analysis into the differences between these two populations is warranted.

This is a 2021 ARVO Annual Meeting abstract.