The Association between Gestational Age and Risk for Long Term Ophthalmic Morbidities among Offspring Delivered in Different Preterm Subgroups

Abstract

Objective: To investigate whether there is a linear association between the degree of prematurity and the risk for long-term ophthalmic morbidity among preterm infants. Study design: A population-based, retrospective cohort study, which included all singleton deliveries occurring between 1991 and 2014 at a single tertiary medical center. All infants were divided into four groups according to gestational age categories: extremely preterm births, very preterm births, moderate to late preterm births and term deliveries (reference group). Hospitalizations of offspring up to 18 years of age involving ophthalmic morbidity were evaluated. Survival curves compared cumulative hospitalizations and regression models controlled for confounding variables. Results: During the study period, 243,363 deliveries met the inclusion criteria. Ophthalmic-related hospitalization rates were lower among children born at term (0.9%) as compared with extremely preterm (3.6%), very preterm (2%), and moderate to late preterm (1.4%) born offspring (p < 0.01; using the chi-square test for trends). The survival curve demonstrated significantly different hospitalization rates between the gestational ages (p < 0.001). The regression demonstrated an independent risk for ophthalmic morbidity among extremely preterm born offspring (adjusted hazard ratio 3.8, confidence interval 1.6–9.2, p < 0.01), as well as very preterm and moderate to late preterm (adjusted hazard ratio 2.2 and 1.5, respectively) as compared with term deliveries. Conclusions: The risk for long-term ophthalmic-related hospitalization of preterm offspring gradually decreases as the gestational age increases.

Wide-field digital imaging system for assessing ocular anterior segment development in very preterm infants

“…We retrospectively collected preterm infants examined between June 2021 and June 2022. The inclusion criteria were birth weight ≤1500 g and very preterm birth[ 11 ] (gestational age, GA: 28–32 weeks), including ROP with a favorable outcome. Exclusion criteria included severe systemic disease of the mother and a history of anticipated drug use; premature infants with severe systemic disease; and eye diseases requiring treatment.…”

The Long-term Mediation Role of Cytokines on the Causal Pathway from Maternal Gestational Age to Offspring Visual System: Lifecourse-Network Mendelian Randomization

“…These abnormalities include retinopathy of prematurity (ROP), strabismus, color vision deficits, visual field defects, decreased visual acuity and refractive error [5]. In a retrospective cohort study from the Soroka Univer-sity Medical Center (SUMC), rate of visual disturbances and retinopathy of prematurity (ROP) was significantly higher among the 24-28 gestational weeks group [6]. Kozeis et al [7] found preterm infants were associated with impairment of some aspects of visual function.…”

“Advances in Preterm Delivery”—How Can We Advance Further?

“…Preterm delivery (PTD: <37 gestational weeks) complicates 5–13% of deliveries worldwide [ 1 ], and is a leading cause of perinatal and childhood mortality and morbidity [ 2 , 3 , 4 , 5 ]. PTD is also a risk factor for long-term maternal health complications, including cardiovascular and renal morbidities [ 6 , 7 ].…”

“…Fetal development occurs throughout the entire pregnancy until full term; therefore, when PTD occurs, the newborn is not physiologically and metabolically mature, leading to immediate and long-term complications [ 2 , 3 , 4 , 5 ]. The severity of these complications depends mainly on gestational age at delivery, and increases with reduced gestational age; this is reported by Gutvirtz et al [ 3 ] and Zer at al.…”