Inhibitory effects of maternal smoking on the development of severe retinopathy of prematurity

Abstract

Purpose In this study, the effects of maternal smoking along with other clinical risk factors in developing severe retinopathy of prematurity (ROP) were evaluated. Design A case-control study. Methods Records of newborn infants with an estimated postmenstrual age of 32 weeks or less (n ¼ 86) were reviewed. ROP grading was evaluated in accordance with the International Classification of Retinopathy of Prematurity. Severe ROP was diagnosed when it progressed to stage 3 with plus disease. The factors were first evaluated using a univariate logistic regression analysis between the groups of severe and non-severe ROP, followed by a multivariate logistic regression analysis using STATA version 10 and R version 2.71. Results A low birth weight, a long duration of artificial ventilation and oxygen supplementation, presence of chronic lung disease, and absence of maternal smoking were found to be significantly associated with severe ROP in the univariate logistic regression analysis. In the multivariate logistic regression analysis, maternal smoking was revealed as a significant factor independently associated with the incidence of severe ROP. Conclusions An inhibitory effect of maternal smoking against developing severe ROP is suggested. The mechanism by which smoking may reduce the incidence of severe ROP needs to be further investigated.

Extreme prematurity, treated retinopathy, bronchopulmonary dysplasia and cerebral palsy are significant risk factors for ophthalmological abnormalities at 6.5 years of age

“…Smoking during pregnancy has previously been reported to be associated with a reduced risk of severe ROP and this association was also observed in the present cohort of children (6,14). However, we found no association between smoking and the long-term ophthalmological outcomes.…”

Evaluation of Oxygen Supplementation Status as a Risk Factor Associated with the Development of Severe Retinopathy of Prematurity

“…Lower gestational age, lower birth weight, male gender, larger volume of blood transfusion and longer and more intensive artificial ventilation were previously demonstrated to be associated with severe ROP [2,3,4,5,6,7]. In our study, we found that lower gestational age, lower birth weight, longer duration of DPAP and longer total duration of oxygen use were associated with the incidence of severe ROP in the univariate logistic regression analyses.…”

“…The examined factors included gender, gestational age, birth weight, singleton or multiple birth, and the presence or absence of respiratory distress syndrome, anemia and intraventricular hemorrhage, which are known or speculated to be risk factors for severe ROP [1,2,3,4,5,6]. In addition, duration of artificial ventilation, duration of directional positive air pressure (DPAP), maximum FiO 2 required to achieve target saturation and total duration of oxygen supplementation were also evaluated as the oxygen supplementation status.…”

“…Preventing severe ROP is the most important issue in the ophthalmic care of preterm infants. Previous reports have documented the risk factors for severe ROP in various countries, which include low postmenstrual age, low birth weight and a male gender [2,3,4,5,6,7]. Excessive oxygen supplementation is also known as a potential risk factor for severe ROP, since delivery of a higher oxygen concentration creates a higher risk of developing severe ROP [8].…”

Ophthalmic statistics note 12: multivariable or multivariate: what’s in a name?

“…A senior colleague asks me to critique a paper which reports to have used multivariate statistical methods to suggest an inhibitory effect of maternal smoking on the development of severe retinopathy of prematurity (ROP) 1. S/he is concerned by the paper because the abstract suggests a positive effect of maternal smoking which flies very much against public health messages in general regarding smoking but is reassured by the fact that complex statistical methods, namely multivariate techniques, have been employed.…”