Perinatal Risk Factors for the Retinopathy of Prematurity in Postnatal Growth and Rop Study

ABSTRACT

Objective: To evaluate perinatal risk factors for retinopathy of prematurity (ROP), in a large, broad-risk cohort of premature infants.

Study design: Secondary analysis of data from the Postnatal Growth and ROP (G-ROP) Study, a retrospective cohort study of infants undergoing ROP examinations at 29 North American hospitals in 2006–2012.

Results: Among 7483 infants, 3224 (43.1%) had any ROP and 931 (12.4%) had severe ROP (Type 1 or 2 ROP). In multivariable logistic regression analysis, significant risk factors for any ROP were lower birth weight (BW, odds ratio (OR) = 5.2, <501 g vs. >1250 g), younger gestational age (GA, OR = 32, <25 vs. >29 weeks), 1-min Apgar score <4 (OR = 1.2), race (OR = 1.6, White vs. Black), outborn (OR = 1.5), and delivery room intubation (OR = 1.3); and for severe ROP were lower BW (OR = 20, <501 g vs. >1250 g), younger GA (OR = 30, <25 vs. >29 weeks), male (OR = 1.5), Hispanic ethnicity (OR = 1.8), race (OR = 1.6, White vs. Black), outborn (OR = 1.6), and delivery room intubation (OR = 1.6). Together, these factors predicted well for any ROP (area under ROC curve (AUC) = 0.87) and severe ROP (AUC = 0.89), but BW and GA were the dominant factors for ROP (AUC = 0.86) and severe ROP (AUC = 0.88).

Conclusions: Based on the largest report to date with detailed ROP data from infants meeting current screening guidelines, ROP risk is predominantly determined by the degree of prematurity at birth, with other perinatal factors contributing minimally.

KEYWORDS:

• Risk factors
• retinopathy of prematurity
• perinatal
• birth weight
• gestational age

Acknowledgments

Collaborators: The Postnatal Growth and ROP (G-ROP) Study Group. The G-ROP Study Group investigators include the following: Office of Study Chair: The Children’s Hospital of Philadelphia: Gil Binenbaum, MD, MSCE (principal investigator [PI]), Lauren A. Tomlinson, BS, Trang B. Duros. Data Coordinating Center - University of Pennsylvania Perelman School of Medicine: Gui-shuang Ying, Ph.D (principal investigator [PI]), Maureen G. Maguire, Ph.D, Mary Brightwell-Arnold, BA, SCP, James Shaffer, MS, Maria Blanco BS, Trina Brown BS, Christopher P. Helker, MSPH. Clinical Centers: Albany Medical College: Gerard P. Barry, MD (PI), Marilyn Fisher, MD, MS, Maria V. Battaglia, Alex M. Drach. Johns Hopkins University: Pamela Donohue, ScD (PI), Michael X. Repka, MD, Megan Doherty NNP, Jennifer A. Shepard, CRNP. University at Buffalo (Women & Children‘s Hospital of Buffalo): James D. Reynolds, MD (PI), Erin Connelly. Medical University of South Carolina: Edward Cheeseman, MD, MBA (PI), Carol Bradham, COA, CCRC, Allison McAlpine, Sudeep Sunthankar, Kinsey Shirer, RN. University of Illinois at Chicago: Javaneh Abbasian, MD (PI), Janet Lim, MD. Cincinnati Children’s Hospital Medical Center (Cincinnati Children’s Hospital Medical Center, Good Samaritan Hospital, and University of Cincinnati Medical Center): Michael Yang, MD (PI), Elizabeth L. Alfano, Patricia Cobb. Nationwide Children’s Hospital: David Rogers, MD (PI), Rae R. Fellows, M.Ed., CCRC, Kaitlyn Loh, Madeline A. McGregor, Thabit Mustafa, Rachel E. Reem, MD, Tess Russell, Rebecca Stattler, Sara Oravec. Kapi’olani Medical Center for Women and Children: David Young (PI), Andrea Siu, MPH, RAC, Michele Kanemori. Indiana University (Riley Hospital for Children at Indiana University Health): Jingyun Wang (PI), Kathryn Haider, MD, Elizabeth Hynes, RNC-NIC. University of Iowa Children’s Hospital: Edward F. Bell, MD (PI), Alina V. Dumitrescu, MD, Jonathan M. Klein, MD, Avanthi S. Ajjarapu, Gretchen A. Cress, RN, MPH, Bethany M. Funk, Claire L. Johnson, Angela C. Platt. Loma Linda University (Loma Linda University Children’s Hospital): Leila Khazaeni, MD (PI), Jennifer Dunbar, MD, Kelley Hawkins, Sharon Lee, RN, Lily Sung. University of Louisville (Norton Kosair Children’s Hospital): Rahul Bhola, MD (PI), Michelle Bottorff, COA, Neviana Dimova, MD, MS, Rachel Keith, PhD, MSN, NP-C, Laura Thomas RN, BSN, CCRN. University of Minnesota (Masonic Children’s Hospital, formerly University of Minnesota - Amplatz Children’s Hospital): Jill Anderson, MD (PI), Jordan Gross, Ann Marie Holleschau, CCRP, Andrea Kramer. Vanderbilt Eye Institute and Vanderbilt University Medical Center: (Monroe Carell Jr. Children‘s Hospital at Vanderbilt): David Morrison, MD (PI), Sean Donahue, MD, PhD, Neva Fukuda, CO,Sandy Owings, COA, CCRP, Scott Ruark. University of Oklahoma (Children’s Hospital at Oklahoma University Medical Center): R. Michael Siatkowski, MD (PI), Faizah Bhatti, MD, Vanessa Bergman, COT, CCRC, Karen Corff, APRN, NNP, Kari Harkey, RNC-NIC, Amy Manfredo, APRN-CNP, Shrenik Talsania, MBBS, MPH, CPH, Terri Whisenhunt, MS, RN. The Children’s Hospital of Philadelphia (The Children’s Hospital of Philadelphia and Hospital of the University of Pennsylvania): Gil Binenbaum, MD, MSCE (PI), Haresh Kirpalani, MD, MSc, Graham E. Quinn MD, MSCE, Lindsay Dawson, MD, Lauren A. Tomlinson, BS. Rhode Island Hospital (Women and Infants Hospital of Rhode Island): Wendy S. Chen, MD, PhD (PI), Deidrya Jackson. Saint Louis University (Cardinal Glennon Children’s Hospital): Bradley Davitt, MD (PI), Dawn Govreau, COT, Linda Breuer, LPN, September Noonan, RN. University of Utah (University of Utah Hospital): Robert Hoffman, MD (PI), Joanna Beachy, MD, PhD, Deborah Harrison, MS, Ashlie Bernhisel, Bonnie Carlstrom, Katie Jo Farnsworth, CRC. University of California San Francisco (UCSF Benioff Children’s Hospital and Zuckerberg San Francisco General Hospital, formerly San Francisco General Hospital): Alejandra G. de Alba Campomanes, MD, MPH (PI), Jacquelyn Kemmer, Alexandra Neiman, Sarah Sitati-Ng’Anda MD. Seattle Children’s Hospital (University of Washington Medical Center): Francine Baran, MD (PI), Kristina Tarczy-Hornoch, MD, D.Phil, (PI) Lauren Eaton. The Hospital for Sick Children (Sick Kids), Toronto: Nasrin Najm-Tehrani, MD, MSc (PI), Maram Isaac, Robin Knighton. Los Angeles Biomedical Research Institute (Harbor-UCLA Medical Center): Monica Ralli Khitri, MD (PI), Madeline Del Signore, RN. Crozer-Chester Medical Center: Cynthia Dembofsky, MD (PI), Andrew Meyer, MD, (PI), Karen Flaherty, Tracey Harris, Jamie Heeneke. Nemours/Alfred I. duPont Hospital for Children: Christopher M. Fecarotta, MD (PI), Dorothy Hendricks, MD (PI), Alicia Olivant Fisher, MS, Mark Paullin, MS. Cost-Effectiveness Component: Beth Israel Deaconess Medical Center: John Zupancic, MD, MS, ScD (PI). Executive/Editorial Committee: Alejandra de Alba Campomanes, MD MPH, Edward F. Bell, MD, Gil Binenbaum, MD, MSCE, Pamela Donohue, ScD, David Morrison, MD, Graham E. Quinn, MD, MSCE, Michael X. Repka, MD, David L. Rogers, MD, Lauren A. Tomlinson BS, Michael Yang, MD, Gui-shuang Ying, PhD.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

Supported by National Eye Institute of the National Institutes of Health, Department of Health and Human Services [R01EY021137].