Pregnancy disorders appear to modify the risk for retinopathy of prematurity associated with neonatal hyperoxemia and bacteremia

Abstract

Objective: To explore (1) whether extremely low gestational age newborns exposed to inflammation-associated pregnancy disorders differ in retinopathy of prematurity (ROP) risk from infants exposed to placenta dysfunction-associated disorders, and (2) whether ROP risk associated with postnatal hyperoxemia and bacteremia differs among infants exposed to these disorders.

Methods: Pregnancy disorders resulting in preterm birth include inflammation-associated: preterm labor, prelabor premature rupture of membranes (pPROM), cervical insufficiency, and abruption and placenta dysfunction-associated: preeclampsia and fetal indication. The risk of severe ROP associated with pregnancy disorders was evaluated by multivariable analyses in strata defined by potential effect modifiers, postnatal hyperoxemia and bacteremia.

Results: Compared to preterm labor, infants delivered after pPROM were at reduced risk of plus disease (Odds ratio = 0.4, 95% confidence interval: 0.2–0.8) and prethreshold/threshold ROP (0.5, 0.3–0.8). Infants delivered after abruption had reduced risk of zone I ROP (0.2, 0.1–0.8) and prethreshold/threshold ROP (0.3, 0.1–0.7). In stratified analyses, infants born after placenta dysfunction had higher risks of severe ROP associated with subsequent postnatal hyperoxemia and bacteremia than infants born after inflammation-associated pregnancy disorders.

Conclusion: Infants exposed to placenta dysfunction have an increased risk of severe ROP following postnatal hyperoxemia and bacteremia compared to infants exposed to inflammation-associated pregnancy disorders.

• Bacteremia
• ELGAN
• hyperoxemia
• pregnancy
• retinopathy of prematurity

Acknowledgements

The authors gratefully acknowledge the contributions of their subjects, and their subjects’ families, as well as those of their colleagues.

Participating institutions (site principal investigator, and colleagues)

Baystate Medical Center, Springfield, MA (Bhavesh Shah, Glen Markenson, William Seefeld, Karen Christianson)

Beth Israel Deaconess Medical Center, Boston, MA (Camilia R. Martin, Bruce Cohen, Deborah Vanderveen Colleen Hallisey, Caitlin Hurley, Miren Creixell)

Brigham & Women's Hospital, Boston, MA (Linda J. Van Marter, Tom McElrath, Deborah Vanderveen)

Children’s Hospital, Boston, MA (Alan Leviton, Kathleen Lee, Anne McGovern, Elizabeth Allred, Jill Gambardella, Susan Ursprung, Ruth Blomquist)

Massachusetts General Hospital, Boston, MA (Robert Insoft, Laura Riley, Anthony Fraioli, Jennifer G. Wilson, Maureen Pimental)

New England Medical Center, Boston, MA (Cynthia Cole, John Fiascone, Sabrina Craigo, Theresa Marino, Jay Duker, Janet Madden, Ellen Nylen, Anne Furey)

U Mass Memorial Health Center, Worcester, MA (Francis Bednarek, Ellen Delpapa, Robert Gise, Mary Naples, Beth Powers)

Yale-New Haven Hospital, New Haven, CT (Richard Ehrenkranz, Keith P. Williams, Kathleeen Stoessel, Joanne Williams, Elaine Romano)

Forsyth Hospital, Baptist Medical Center, Winston-Salem, NC (T. Michael O’Shea, Maggie Harper, Grey Weaver, Debbie Gordon, Teresa Harold, Gail Hounsell, Debbie Hiatt)

University Health Systems of Eastern Carolina, Greenville, NC (Stephen Engelke, Hamid Hadi Sherry Moseley, Linda Pare, Donna Smart, Joan Wilson)

North Carolina Children's Hospital, Chapel Hill, NC (Carl Bose, Kim Boggess, David Wallace, Gennie Bose, Janice Wereszczak)

DeVos Children's Hospital, Grand Rapids, MI (Mariel Portenga, Curtis Cook, Pat Droste, Dinah Sutton)

Sparrow Hospital, Lansing, MI (Padmani Karna, Steve Roth, Linda Angell, Carolyn Solomon)

University of Chicago Hospital, Chicago, IL (Michael D. Schreiber, Mahmoud Ismail, Ahmed Abdelsalam, Grace Yoon)

William Beaumont Hospital, Royal Oak, MI (Daniel Batton, Robert Lorenz, Anthony Capone, Michael Trese, Beth Kring)