November 8, 2013
Study Finds Link Between Pre-Term Births, Retinal Detachment
redOrbit Staff & Wire Reports - Your Universe Online
According to new research appearing this month in Ophthalmology, the journal of the American Academy of Ophthalmology (AAO), premature children face a much greater risk of eventually experiencing retinal detachment than their full-term counterparts.
In the first large-scale, population-based investigation into the link between preterm birth and later retinal detachment, researchers discovered a link between birth before 32 weeks and the risk of retinal detachment during childhood, adolescence and young adult life.
In fact, premature babies face up to a 19-times greater risk of having the light-sensitive membrane in the rear of the eye separate from its supporting layers. The authors report that their findings indicate the need for ophthalmologic follow-up exams in children and adults who were born very early in the gestation period.
The authors used Swedish population registries of over three million births occurring from 1973 through 2008 to identify individuals born at less than 37 weeks of gestation. Those individuals were then separated into two groups – those born between 1973 and 1986 – prior to the establishment of a national retinopathy of prematurity (ROP) screen program – and those born afterwards, from 1987 through 2008.
“ROP is a condition that causes abnormal blood vessels to grow in the retina (back of the eye) and can cause retinal detachment, which is a major cause of childhood blindness globally. A detached retina may lead to vision loss and even blindness unless it is treated with surgery,” the AAO explained in a statement. While other researchers have reported the link between retinal detachment and preterm births, the newly-published study is said to be the first to analyze the topic in a far larger population.
Children born extremely premature (less than 28 weeks of gestation) between 1973 and 1986 were found to have a risk of retinal detachment 19 times higher than peers born at term. The same children born between 1987 and 2008 were found to have a nine-fold increase following adjustment for possible confounding factors.
Those born very prematurely (28 to 31 weeks of gestation) between 1973 and 1986 had a four-fold increased risk, while very premature children born post-ROP screening had a three-fold greater risk than those born following a full gestation period. No increased risk of retinal detachment was found in moderately premature (32 to 36 weeks of gestation) children, the study authors reported.
“We may just be seeing the tip of the iceberg of late ophthalmic complications after preterm birth,” said lead researcher Dr. Anna-Karin Edstedt Bonamy, a pediatrician at the Karolinska Institutet in Stockholm. “Not only does the risk of retinal detachment increase with age, but there has also been an increase in survival among people born prematurely since the 1970s. This provides opportunities for future research to address if the increased risk persists among those born prematurely as they age.”
According to the AAO, they – along with the American Academy of Pediatrics and other related groups, “recommend screening for ROP in infants born at less than 30 weeks of gestation or those with a birth weight of less than [3.3 pounds] (or those with a birth weight of less than [4.4 pounds] with an unstable clinical course).” The organization also notes that the researchers “recommend that individuals who have been treated for ROP in the neonatal period should continue follow up on a yearly basis.”