Association of Cardiovascular Disease with Retinopathy of Prematurity

ABSTRACT

Purpose

To determine the associations of presence and types of cardiovascular diseases (CVDs) with development of retinopathy of prematurity (ROP) in premature infants undergoing ROP examinations.

Study Design

We performed secondary analyses of data from the multi-center Postnatal Growth and ROP Validation Study (GROP-2). CVD was categorized based on pulmonary blood flow (PBF), systemic blood flow (SBF), pulmonary hypertension (PPHN), or dysrhythmia. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were calculated from multivariable logistic regression models that included any ROP or severe ROP as outcome variable and any CVD or type of CVD as independent variable, with adjustment of covariates including birth weight (BW), gestational age (GA), and days on supplemental oxygen in the first month of postnatal life.

Result

Among 3980 infants, 528 (13.3%) had CVD (304 had increased PBF, 101 had decreased PBF, and 49 had PPHN), 1643 (40.4%) developed ROP, and 503 (12.6%) developed severe ROP. In multivariable analyses, presence of CVD was not significantly associated with increased risk of any ROP (aOR = 1.15, 95% CI: 0.90–1.46, p = .26) or severe ROP (aOR = 0.98, 95% CI: 0.72–1.34, p = .92). However, there were trends associating CVD resulting in increased PBF with a higher risk of ROP (aOR = 1.32, 95% CI: 0.97–1.80, p = .08) and PPHN with a higher risk of severe ROP (aOR = 2.04, 95% CI: 0.96–4.35, p = .07). When adjusting only for BW and GA, these associations were significant (aOR = 1.47, 95% CI: 1.09–1.99, and aOR = 2.35, 95% CI: 1.19–4.65, respectively).

Conclusion

CVD with increased PBF likely increases the risk of ROP. PPHN likely increases the risk of severe ROP.

Keywords:

• Retinopathy of Prematurity
• Congenital Cardiac Disease
• Pulmonary Hypertension

Acknowledgments

The authors would like to thank Kathy Kyler at the University of Oklahoma Health Sciences Center Office of Research Administration for editorial assistance with the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

FB – Conception and design, interpretation of data, drafting and revision of article, and final approval.

YY – Analysis and interpretation of data, revision of article, and final approval.

GY – Design, acquisition, analysis, and interpretation of data, drafting article, and final approval.

LT – Acquisition and interpretation of data, revision of article, and final approval.

GB – Design, acquisition, analysis, and interpretation of data, revision of article, and final approval

Additional information

Funding

This study was supported by the National Institutes of Health [R01EY021137, R21EY029776] and the Richard Shafritz Endowed Chair in Ophthalmology Research at the Children’s Hospital of Philadelphia.