Children born prematurely face up to a 19 times greater risk of retinal detachment later in life

November 07, 2013

SAN FRANCISCO - Nov. 7, 2013 - Children born extremely prematurely have up to a 19 times greater risk of retinal detachment later in life than peers born at term, according to a Swedish study published this month in Ophthalmology, the journal of the American Academy of Ophthalmology. In the first large population-based, long-term investigation of the association between preterm birth and later retinal detachment, the research determined that birth before 32 weeks is associated with increased risks of retinal detachment in childhood, adolescence and young adult life. The study's findings indicate the need for ophthalmologic follow-up in children and adults born extremely and very prematurely. The United States has the sixth largest number of premature births, with more than 500,000 premature babies born each year.

The researchers used Swedish nationwide population registries of more than three million births from 1973 to 2008 to identify subjects born prematurely (at less than 37 weeks of gestation), who were then separated into two groups: those born between 1973 and 1986, at which point a national retinopathy of prematurity (ROP) screening program was established, and those born between 1987 and 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. Although the connection between retinal detachment and preterm births has been noted in smaller studies, this is the first study to analyze a population of this size.

For those born extremely prematurely (less than 28 weeks of gestation) between 1973 and 1986, the researchers found the risk of retinal detachment was 19 times higher than peers born at term. Those born extremely prematurely between 1987 and 2008 had a nine-fold increase in risk after adjustment for potential cofounders.

Those born very prematurely (28 to 31 weeks of gestation) between 1973 and 1986 had a four-fold increased risk and those born very prematurely between 1987 and 2008 had a three-fold greater risk than those born at term. Additionally, the researchers found that moderately preterm birth (32 to 36 weeks of gestation) was not associated with an increased risk of retinal detachment.

"We may just be seeing the tip of the iceberg of late ophthalmic complications after preterm birth," said Anna-Karin Edstedt Bonamy, M.D., Ph.D., pediatrician at Karolinska Institutet in Stockholm and the study's lead researcher. "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."

Clinical studies and care series indicate that individuals born prematurely may be at lifelong risk for ophthalmologic complications other than ROP. This includes an increased risk of subnormal visual acuity, visual perceptual problems, strabismus, refractive errors (particularly high myopia) and reduced contrast sensitivity and visual fields.

The American Academy of Pediatrics, along with the American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus and the American Association of Certified Orthoptists recommend screening for ROP in infants born at less than 30 weeks of gestation or those with a birth weight of less than 1500 grams (or those with a birth weight of less than 2000 grams with an unstable clinical course).

Although follow-up guidelines vary from country to country, the researchers recommend that individuals who have been treated for ROP in the neonatal period should continue follow up on a yearly basis.
-end-
About the American Academy of Ophthalmology

The American Academy of Ophthalmology, headquartered in San Francisco, is the world's largest association of eye physicians and surgeons -- Eye M.D.s -- with more than 32,000 members worldwide. Eye health care is provided by the three "O's" - ophthalmologists, optometrists, and opticians. It is the ophthalmologist, or Eye M.D., who has the education and training to treat it all: eye diseases, infections and injuries, and perform eye surgery. For more information, visit http://www.aao.org. The Academy's EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program. Visit http://www.geteyesmart.org or http://www.ojossanos.org to learn more.

About Ophthalmology

Ophthalmology, the official journal of the American Academy of Ophthalmology, publishes original, peer-reviewed, clinically applicable research. Topics include the results of clinical trials, new diagnostic and surgical techniques, treatment methods, technology assessments, translational science reviews and editorials.

American Academy of Ophthalmology

Related Preterm Birth Articles from Brightsurf:

Researchers develop app to determine risk of preterm birth
An improved mobile phone app will help identify women who need special treatments at the right time and reduce emotional and financial burden on families and the NHS.

Point-of-care diagnostic for detecting preterm birth on horizon
A new study provides a first step toward the development of an inexpensive point-of-care diagnostic test to assess the presence of known risk factors for preterm birth in resource-poor areas.

WVU biostatistician studies link between microbiome and preterm birth
Pregnant African American women are more likely than white women to give birth prematurely, but they're underrepresented in studies of preterm birth rates.

3D-printed device detects biomarkers of preterm birth
Preterm birth (PTB) -- defined as birth before the 37th week of gestation -- is the leading complication of pregnancy.

Association of quitting smoking during pregnancy, risk of preterm birth
This study of more than 25 million pregnant women reports on rates of smoking cessation at the start of and during pregnancy and also examines the association of quitting cigarette smoking and the risk of preterm birth.

Blood test developed to predict spontaneous preterm birth
Results from a multicenter study show that five circulating microparticle proteins found in first-trimester blood samples may provide important clues about risk of spontaneous preterm birth.

Scientists gain new insight on triggers for preterm birth
A group of scientists led by Ramkumar Menon at The University of Texas Medical Branch at Galveston have gained new insight on a poorly-understood key player in the timing of labor and delivery.

Medically assisted reproduction does not raise risk of preterm birth and low birth weight
Study shows that couples can decide about using medically assisted reproduction free from concerns about increasing the health risks to their baby.

Risk of preterm birth reliably predicted by new test
Scientists at UC San Francisco have developed a test to predict a woman's risk of preterm birth when she is between 15 and 20 weeks pregnant, which may enable doctors to treat them early and thereby prevent severe complications later in the pregnancy.

Preterm birth leaves its mark in the functional networks of the brain
Researchers at the University of Helsinki and the Helsinki University Hospital, Finland, have proven that premature birth has a significant and, at the same time, a very selective effect on the functional networks of a child's brain.

Read More: Preterm Birth News and Preterm Birth Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.