scholarly journals Is Artificial Reproductive Technology a Risk Factor for Retinopathy of Prematurity Independent of the Generation of Multiple Births?

2016 ◽  
Vol 27 (2) ◽  
pp. 174-178 ◽  
Author(s):  
Lucy Barker ◽  
Catey Bunce ◽  
Shahid Husain ◽  
Gill G.W. Adams
Keyword(s):  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Reproductive Technology ◽  
Multiple Births ◽  
Considerable Proportion ◽  
Multiple Birth ◽  
Retrospective Audit ◽  
Significant Difference ◽  
Artificial Reproductive Technology ◽  
Rop Screening

Purpose There is some debate regarding whether artificial reproductive technology (ART) constitutes an independent risk factor for retinopathy of prematurity (ROP). We wanted to assess the prevalence of ART in multiple birth infants seen for ROP screening and whether or not ROP was identified or treated, in order to evaluate whether ART contributes a risk factor for ROP independent of the generation of multiple births. Methods A retrospective audit was performed of all multiple birth babies admitted to a tertiary neonatal unit who met the UK ROP screening criteria (<32 weeks gestational age [GA] and/or <1,501 g birthweight [BW]). Results A total of 205 babies met our criteria, of whom 87.3% were twins. A total of 39.5% were born following ART. A total of 30.5% of the non-ART group developed ROP vs 34% of the ART group (p = 0.837). Stage 3 ROP developed in 5.1% of non-ART babies and 6% of ART babies. A total of 8.5% of non-ART babies and 10% of ART babies required treatment for ROP. Logistic regression demonstrated that ART was not independently associated with development of ROP. Conclusions Artificial reproductive technology multiple birth babies make up a considerable proportion of the ROP screening burden and their number is likely to increase as ART is increasingly available and utilized. We found no significant difference between the numbers of babies developing ROP in the ART vs non-ART groups, but the numbers are small. The estimated odds of developing ROP are slightly higher in the ART babies, so our data do not rule out a possible association.

scholarly journals Artificial Reproductive Technology – A Risk Factor for Retinopathy of Prematurity

2018 ◽  
Vol 6 (11) ◽  
pp. 2245-2249 ◽  
Author(s):  
Kalina Trifonova ◽  
Kiril Slaveykov ◽  
Hristo Mumdzhiev ◽  
Dimitar Dzhelebov
Keyword(s):  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Risk Group ◽  
Meta Analysis ◽  
Fold Increase ◽  
Reproductive Technology ◽  
Premature Babies ◽  
Background Retinopathy ◽  
Significant Pathology ◽  
Artificial Reproductive Technology

BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease in premature babies. The presentation and course of ROP are determined by a complex interaction of a series of risk factors, including artificial reproductive technology (ART). AIM: To analyse and combine the information relating ART as an independent risk factor for retinopathy of prematurity. METHODS AND MATERIAL: The article is systematic review and meta-analysis using RevMan 5. Pubmed, Scopus and Medline were searched for articles from 1990 to 2018. RESULTS: Studies suggest that ROP is observed more frequently in ART children. They are more likely to be premature and of low birth weight than those conceived naturally. Results vary from just a tendency to a five-fold increase in risk to develop ROP in ART babies. At the same time, they might develop ROP later, and more mature newborns might be affected. CONCLUSION: The data relating ART as a risk factor for ROP is inconclusive, but most studies show at least a tendency. The ART newborns need to be considered as a risk group for ROP and observed with greater suspicion. Even more mature ART newborns might need to be screened in order not to miss any significant pathology.

scholarly journals Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Kasia Trzcionkowska ◽  
Floris Groenendaal ◽  
Peter Andriessen ◽  
Peter H. Dijk ◽  
Frank A.M. van den Dungen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
The Netherlands ◽  
Retinopathy Of Prematurity ◽  
Screening Guideline ◽  
Potential Risk Factors ◽  
Second Period ◽  
Perinatal Database ◽  
Rop Screening

<b><i>Introduction:</i></b> Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. <b><i>Methods:</i></b> Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. <b><i>Results:</i></b> Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation &#x3e;7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). <b><i>Conclusion:</i></b> In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.

Early postnatal hyperglycaemia is a risk factor for treatment-demanding retinopathy of prematurity

2017 ◽  
Vol 102 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Carina Slidsborg ◽  
Louise Bering Jensen ◽  
Steen Christian Rasmussen ◽  
Hans Callø Fledelius ◽  
Gorm Greisen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Study Groups ◽  
Multivariate Logistic Regression Model ◽  
Multiple Birth ◽  
Retrospective Case ◽  
Matching Criteria

BackgroundTo investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP).MethodsThis is a Danish national, retrospective, case–control study of premature infants (birth period 2003–2006). Three national registers were searched, and data were linked through a unique civil registration number. The study sample consisted of 106 cases each matched with two comparison infants. Matching criteria were gestational age (GA) at birth, ROP not registered and born at the same neonatal intensive care unit. Potential ‘new’ risk factors were analysed in a multivariate logistic regression model, while adjusted for previously recognised risk factors (ie, GA at birth, small for gestational age, multiple birth and male sex).ResultsHospital records of 310 preterm infants (106 treated; 204 comparison infants) were available. Nutrition in terms of energy (kcal/kg/week) and protein (g/kg/week) given to the preterm infants during the first postnatal week were statistically insignificant between the study groups (Mann-Whitney U test; p=0.165/p=0.163). Early postnatal weight gain between the two study groups was borderline significant (t-test; p=0.047). Hyperglycaemic events (indexed value) were statistically significantly different between the two study groups (Mann-Whitney U test; p<0.001). Hyperglycaemia was a statistically independent risk factor (OR: 1.022; 95% CI 1.002 to 1.042; p=0.031).ConclusionAn independent association was found between the occurrence of hyperglycaemic events during the first postnatal week and later development of treatment-demanding ROP, when adjusted for known risk factors.

Multiple Births and Congenital Anomalies in Tokyo Metropolitan Hospitals, 1979-1990

1992 ◽  
Vol 41 (4) ◽  
pp. 253-259 ◽  
Author(s):  
K. Kato ◽  
K. Fujiki
Keyword(s):  
Respiratory Tract ◽  
Cardiovascular System ◽  
Musculoskeletal System ◽  
Congenital Anomalies ◽  
Multiple Births ◽  
Multiple Birth ◽  
Upper Respiratory Tract ◽  
Tokyo Metropolitan ◽  
Significant Difference ◽  
Upper Respiratory

AbstractThe rate of multiple births and the incidence of congenital anomalies in Tokyo Metropolitan Hospitals were studied during the period 1979-1990. The number of twins was 968 pairs (8.23 per 1,000 deliveries) and of triplets 18 sets (15.3 per 100,000 deliveries) among 117,672 deliveries including 1,587 stillbirths after 16 weeks gestation. Multiple birth rates increased yearly. Stillbirth rates in twins and triplets were 5.5% and 16.7% respectively, which were both significantly higher than that in singletons (1.3%). The number of congenital anomalies was 42 in 1,936 twins (2.17%), 2 in 54 triplets (3.7%) and 1721 in 116,686 singletons (1.47%). The most common defects in twins were those of the cardiovascular system (0.72% in twins vs 0.52% in singletons) and of the musculoskeletal system (0.72% in twins vs 0.50% in singletons), followed by upper respiratory tract and/or mouth conditions (0.67% in twins vs 0.35% in singletons), all of which had no significant difference in frequency between twins and singletons. Though some anomalies had a significantly higher frequency in twins than in singletons, the concordance rate in the like-sexed twins was very low.

Estimation of the Contribution of Assisted and Non-Assisted Reproductive Technology Fertility Treatments to Multiple Births During the Past 30 Years in Japan: 1979–2008

2011 ◽  
Vol 14 (5) ◽  
pp. 476-483 ◽  
Author(s):  
Syuichi Ooki
Keyword(s):  
Assisted Reproductive Technology ◽  
Social Impact ◽  
Vital Statistics ◽  
Reproductive Technology ◽  
Multiple Births ◽  
Fertility Treatment ◽  
Approximation Formula ◽  
Multiple Birth ◽  
Fertility Treatments ◽  
Ovulation Stimulation

The effect of assisted reproductive technology (ART) and non-ART ovulation stimulation fertility treatment on the number and rate of multiple live births from 1979–2008 in Japan was estimated using two independent data sources, ART statistics and vital statistics. Japanese ART statistics presented by the Japan Society of Obstetrics and Gynecology between 1989 and 2008 were gathered and reanalyzed. The number and rates of ART between 1984 and 1988 were interpolated using an approximation formula, using the values from 1983, when the first ART baby was born in Japan, and the 1989–1992 values. The number of ART multiples between 1979–1982 was set as equal to zero. The minimum (or maximum) number of non-ART iatrogenic multiple births was estimated by subtracting the maximum (or minimum) ART multiples from the total iatrogenic multiples, which was estimated by vital statistics assuming that spontaneous multiple-birth rates according to maternal age class would be constant. There was an overall increase in the non-ART multiple births during the 30-year period, whereas ART multiples tended to increase from 1983 to 2005, and then rapidly decreased thereafter. The number or percentage of ART multiples was almost consistently lower than that of non-ART multiples. The percentage of non-ART multiples (33%) among the total multiples was estimated to be about three times more than the ART multiples (11–12%) in 2008. Given the medical and social impact of multiple births, it is imperative to construct a hospital-based monitoring system for fertility treatments, specially non-ART fertility treatments and multiple births.

scholarly journals Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

2021 ◽  
Vol 18 (13) ◽  
pp. 7054
Author(s):  
Edwin Pheng ◽  
Zi Di Lim ◽  
Evelyn Tai Li Min ◽  
Hans Van Rostenberghe ◽  
Ismail Shatriah
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Analysis Of Covariance ◽  
Postnatal Life ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Main Component ◽  
Rop Screening

Retinopathy of prematurity (ROP) is a proliferative retinal vascular disorder attributed to an ischaemic stimulus in preterm infants. Haemoglobin, the main component for oxygen transportation, may be implicated in ROP development. This retrospective study compared the mean weekly haemoglobin levels between infants with and without ROP over the first six weeks of life. Premature infants of less than 32 weeks gestational age and less than 1.5 kg birth weight were grouped into age and birth weight-matched ROP cases and controls. Weekly mean haemoglobin levels were documented. An independent t-test was used to analyze the difference in mean haemoglobin levels between infants with ROP and infants without ROP. Adjustment for confounders was performed using one-way analysis of covariance. There was a statistically significant difference in adjusted mean haemoglobin levels between the ROP and non-ROP group during the first week of life (p = 0.038). No significant intergroup differences were observed at the other weeks. Haemoglobin monitoring during the first week of postnatal life may be useful to guide ROP screening in premature infants.

scholarly journals THE EFFECT OF EYEMASKS ON REDUCING DISTRESS ASSOCIATED WITH THE RETINOPATHY OF PREMATURITY EXAM

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e24-e24
Author(s):  
Matthew Speckert ◽  
Andrei-Alexandru Szigiato ◽  
Jeanne zielonka ◽  
Kathleen Hollamby ◽  
Eugene Ng ◽  
...  
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Stressful Events ◽  
Control Group ◽  
Ventilator Support ◽  
Significant Difference ◽  
Rop Screening

Abstract BACKGROUND Retinopathy of prematurity (ROP) is a disorder of retinal development in the low birthweight preterm infant. Eye screening is routinely performed for infants at risk of developing this disorder. While these examinations help prevent blindness, they can be physiologically stressful for infants, with changes in oxygen saturation, blood pressure and heart rate occurring during the exam and increased apneic episodes reported the 24–48 hours period afterward. The cause of these increased apneic episodes is not currently known. OBJECTIVES To evaluate the effect of decreasing light simulation during mydriasis on the frequency of stressful episodes after ROP screening. DESIGN/METHODS Multi-centre randomized study. This study was approved by hospital ethics boards at all sites. After informed consent was obtained, infants with a birthweight <1500g or gestational age of ≤32 weeks and scheduled for their first ROP screening were randomized to receive either standard of care or a phototherapy mask during pupil dilation, in addition to routine care. Dilated retinal exams were performed by retinal surgeons and fellows. The primary outcome was the frequency of any desaturation, bradycardic event, or apneic event 12 hours following the examination, compared to a baseline rate 12 hours prior to the exam. Heart rate, respiratory rate and oxygen saturation were recorded for up to 48 hours following the examination and compared to baseline. RESULTS A total of 51 infants were enrolled; 28 randomized to the masked group and 23 to the control group. 10 and 13 infants were on ventilator support at the time of examination in each group, respectively. There was a 57.7% decrease in the total number of all stressful events in the masked group compared to controls in the 12 hour post exam period (Rate Ratio 0.42, 95% CI 0.2–0.9, P=0.024). There was a 61.3% decrease in the number of bradycardic events in the masked group compared to controls (RR 0.39, 95% CI 0.2–1.0, P=0.042). Heart rate was significantly higher in both groups after the exam (Effect by time P=0.04), with no difference in between groups (Effect by group P=0.31). There was no significant difference seen in either group in respiratory rate or oxygen saturation at 2 or 4 hours after the ROP examination compared to baseline. Risk factors that were associated with increased stress included: younger gestational age (RR=1.32 95%CI [1.2–1.5] per week), lower birthweight (RR=1.39 [1.2–1.5] per 100g), ventilator support around the time of exam (RR=2.67 [1.3–5.6]), diagnosis of intraventricular hemorrhage (RR=3.78 [1.9–7.3]), and hyponatremia (RR=3.42 [1.8–6.6]). No adverse events occurred while using eye masks. CONCLUSION The infants who wore a phototherapy mask during pupillary dilation had lower rates of stressful episodes following screening for retinopathy of prematurity, particularly lower episodes of bradycardia.

scholarly journals Association between Artificial Reproductive Technology and Retinopathy of Prematurity

2021 ◽  
Vol 9 (B) ◽  
pp. 6-11
Author(s):  
Kiril Slaveykov ◽  
Kalina Trifonova ◽  
Hristo Mumszhiev
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Significant Risk ◽  
Reproductive Technology ◽  
Reproductive Age ◽  
University Hospital ◽  
Screening Criteria ◽  
Logistic Regression Models ◽  
Artificial Reproductive Technology

BACKGROUND: Infertility is an increasingly common health problem which affects approximately 10% of the women in reproductive age. Artificial reproductive technology (ART), which is the modern solution to infertility, unfortunately has been linked to increased prevalence of prematurity and low birth weight (BW) in the newborn. That’s why ART infants make up a considerable portion of the retinopathy of prematurity (ROP) screening burden, which is likely to increase, as ART becomes increasingly available and utilized. AIM: The aim of the study was to assess the association between ART and the development of ROP. MATERIALS AND METHODS: Retrospective analysis of preterm infants screened for ROP at the Neonatal Intensive Care Unit in the University Hospital â€oeProf. Dr. Stoyan Kirkovich” Stara Zagora, Bulgaria, by single factor and multifactor logistic regression models. RESULTS: During a 4-year period (2016–2019), 419 infants, meeting the screening criteria, were admitted in the ward. Out of them, 265 were conceived naturally and 154 through ART. Thirty-two (7.6%) children required laser treatment for ROP, among which 15 (46.87%) were conceived naturally and 17 (53.12%) by ART. Multifactor analyses proves BW (odds ratio [OR] 0.99; confidence interval [CI], 0.98–0.99; p = 0.008) and gestational age (GA) (OR 0.296; 95% CI 0.09–0.88; p = 0.029) as significant risk factors for severe ROP, requiring treatment. CONCLUSION: ART is a risk factor for ROP due to its association with lower BW and GA of the newborn infants, rather than directly increasing the possibility for it. Nevertheless, there is a pronounced trend for more severe ROP to develop in ART children, when compared to naturally conceive in the same weight group.

scholarly journals Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme

2020 ◽  
Vol 47 (2) ◽  
pp. 55-60
Author(s):  
B.A. Olusanya ◽  
T.S. Oluleye ◽  
O.O. Tongo ◽  
M.O. Ugalahi ◽  
Y.O. Babalola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Screening Criteria ◽  
Screening Programs ◽  
Significant Difference ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Rop Screening

Background: Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the  development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening  program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks.  Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those  without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening  programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards  developing country-specific screening guidelines. Keywords: Retinopathy; Prematurity; Preterm; Neonates; Nigeria; Africa

scholarly journals Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
K. M. Friddle ◽  
B. A. Yoder ◽  
M. E. Hartnett ◽  
E. Henry ◽  
R. J. DiGeronimo
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Risk Factor ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Incomplete Data ◽  
Significant Risk ◽  
Screening Strategy ◽  
Screening Guidelines ◽  
Rop Screening

Objective.Current American retinopathy of prematurity (ROP) screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP.Study Design.We performed a 13-year review from Intermountain Health Care (IHC) data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP.Results.We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61%) were included in the study. Overall, severe ROP occurred in 260 (9.3%), but only 11/1601 ≥ 29 weeks (0.7%). All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601) of the screened population.Conclusions.Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.

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