A study published in Retina, led by researchers from the University of California, Los Angeles, evaluated the potential relationship between prenatal maternal characteristics and the development of retinopathy of prematurity (ROP).
Give me some background.
Research on ROP risk factors has mostly focused on peri- and postnatal variables, leaving the impact of prenatal variables on ROP relatively unknown.
Current guidelines for screening ROP recommend checking infants born at 30 weeks gestational age (GA), infants with a birthweight (BW) of 1,500 g, and infants deemed to be at increased risk based on their clinical course.
Talk about the study.
Researchers in the retrospective cohort study reviewed the medical records of 236 mother-infant dyads; only dyads where infants were born at 22 to 30 weeks GA or earlier were included.
Using logistic regression modeling and analyses, investigators evaluated potential prenatal ROP risk factors, including maternal sociodemographic information, maternal and neonatal comorbidities, and pregnancy complications.
What were the findings?
In unadjusted analyses, Medicaid insurance (odds ratio [OR] 2.12, P = 0.013), smoking during pregnancy (OR 5.14, P = 0.048), and chorioamnionitis (OR 5.25, P = 0.001) were significantly associated with an increased risk for any stage of ROP.
Tell me more.
Even after adjusting for potential confounders, Medicaid insurance and chorioamnionitis remained statistically significant as independent risk factors for ROP.
Compared with nonsmokers, smoking during pregnancy resulted in a three-fold increased risk of ROP. This is backed by multiple studies showing that maternal smoking during pregnancy can lead to deleterious effects on uterine blood flow.
Significance?
The study noted that Medicaid insurance could act as a “surrogate parameter for low-income status or socioeconomic disadvantage,” which is associated with increased rates of preterm infant morbidity.
When treating pregnant patients, physicians should consider maternal sociodemographic characteristics (specifically Medicaid insurance coverage, smoking, and chorioamnionitis), infant comorbidities, and the clinical course of the pregnancy when classifying infants as potentially high risk for ROP.