Abstract
Purpose :
Retinopathy of prematurity (ROP) is an eye disorder primarily affecting premature and low birth weight infants that can lead to lifelong vision impairment and blindness. We used a nationwide pediatric inpatient care database to investigate the variability of incidence of ROP across populations, locations, and time in the US.
Methods :
The National Healthcare Cost and Utilization Project Kids' Inpatient Databases from 2003 to 2016 were analyzed to find the incidence of ROP across sexes, racial groups, income groups, and geographic regions. Infants with ICD-9 codes (ICD-10 for 2016) for premature birth week or low birth weight (<1500 g) were considered premature. Chi-square tests of independence were used to determine whether incidences changed by year or varied across subpopulations.
Results :
The proportion of premature infants diagnosed with ROP has increased from 4.61% in 2003 to 8.54% in 2016. Compared with those born in higher median household income quartiles, premature infants from the lowest quartile had the greatest proportional increase of ROP diagnoses from 5.07% to 9.50% during the same time period (p < 0.001). ROP incidence increased between 2003 and 2016 in all considered racial/ethnic groups, but premature Black infants experienced the largest relative increase from 5.98% to 12.12% (p < 0.01). The Southern US has seen the greatest growth in the proportion of ROP diagnoses increasing from 3.82% to 9.11% (p < 0.001). ROP diagnoses have proportionally increased in urban areas and decreased in rural areas. Premature male and female infants experienced similar relative increases in ROP diagnoses (4.47% to 8.27% vs 4.76% to 8.86%, respectively).
Conclusions :
Overall incidence of ROP among premature infants increased from 2003 to 2016. Infants in the poorest areas have the highest proportional incidence of ROP, and this disparity is persistent over time. Black infants appear to be at the highest risk. All regions have experienced a significant increase in ROP incidence, with the most drastic changes occurring in the South and Midwest. Regardless of region, the burden of ROP seems to have partially shifted from rural hospitals to urban ones. These trends indicate ROP is a growing problem in the United States and one that may be disproportionately affecting certain subpopulations.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.