Abstract
Purpose :
Living in a disadvantaged neighborhood is linked to poor outcomes for preterm infants, who are at risk for developing retinopathy of prematurity (ROP). The goal of this study was to evaluate the association between ROP and social determinants of health (SDOH) using the Area Deprivation Index (ADI), a validated measure of neighborhood-level socioeconomic disadvantage.
Methods :
This cross-sectional study included infants screened for ROP at a single academic center between 2014 and 2022. Screening criteria was gestational age ≤30 weeks or birth weight ≤1500 grams. Infants lacking ROP screening documentation were excluded. Patient demographics, ocular examinations, and ROP treatments were extracted from the electronic medical record. Patient addresses were linked with publicly available census block group ADI scores (range, 0-100), with higher numbers denoting increased neighborhood disadvantage. We used linear and logistic regression models to assess the relationship between gestational age, birth weight, ADI scores, and ROP development.
Results :
This study included 663 infants, 48% female. Mean birth weight was 1058±346 grams and gestational age was 28±3 weeks. 274 [41%] developed ROP of which 36 [5%] required treatment. Compared to infants without ROP, infants with ROP had lower gestational age (median, 26 versus 29 weeks; p<0.001), lower birth weight (median, 800 versus 1225 grams; p<0.001), and greater neighborhood disadvantage (median, 12 versus 7 ADI score; p=0.038). Neighborhood disadvantage was associated with low gestational age (p=0.003) and low birth weight (p=0.004). After adjusting for gestational age and birth weight, the ADI score was not significantly associated with ROP development (p=0.51).
Conclusions :
In our cohort of infants at risk for ROP, we observed an association correlation between neighborhood disadvantage and the development of retinopathy of prematurity (ROP), potentially mediated through an increased risk of prematurity. Our findings align with prior studies, reinforcing known risk factors for ROP. Further investigation is needed to comprehensively understand the pathways through which neighborhood disadvantage may influence the incidence and outcomes of ROP.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.