Abstract
BackgroundTwin infants are likely at great risk for ROP, but studies reported conflicting findings and population studies examining the risk of retinopathy of prematurity (ROP) in twins is limited. We aimed to evaluate the ROP risk in the cohort of one of twins, comparing to singletons.Material and methodsUsing insurance claims data of a half of children in Taiwan ages 18 and less, we established a twin cohort (N = 27830) born in 1998–2009 and a randomly selected singleton cohort (N = 111080) frequency matched by sex, birth year, residential area and parental occupation and followed up to 2012 years.ResultsThe overall incidence rate of ROP was 13.6-fold greater in the twin cohort than in the singleton cohort (35.1 vs. 2.58 per 10,000 person-years; adjusted HR = 13.4, 95% CI = 11.7–15.3; p <0.0001). The ROP incidence was slightly higher in boys than in girls, higher in children in more urbanized areas and born to mothers without works. The incident ROP increased with decreasing birthweight. For children with birthweight <1000 grams, the ROP incidence was 1.2-fold greater in the twin cohort than in the singleton cohort (1243.2 vs. 1016.3 per 10,000 person-years). The use of mechanical ventilation was associated with increased ROP risk for both cohorts, particularly for infants who were under invasive treatment.ConclusionInfants who were born as twins or born with low birthweight were at an elevated risk of developing ROP. Extreme cautious and close monitor are required for new born with low birthweight and have undergone with mechanical ventilation.
Highlights
Retinopathy of prematurity (ROP) is an eye disorder characterized by neurovascular disruption in the immature retina and is known to lead to visual impairments and blindness. [1,2,3,4] This disorder affects mainly the preterm or low birthweight infants who have received oxygen supplementation during the early postnatal care[4,5,6]
Twin infants are likely at great risk for ROP, but studies reported conflicting findings and population studies examining the risk of retinopathy of prematurity (ROP) in twins is limited
The use of mechanical ventilation was associated with increased ROP risk for both cohorts, for infants who were under invasive treatment
Summary
Retinopathy of prematurity (ROP) is an eye disorder characterized by neurovascular disruption in the immature retina and is known to lead to visual impairments and blindness. [1,2,3,4] This disorder affects mainly the preterm or low birthweight infants who have received oxygen supplementation during the early postnatal care[4,5,6]. [14, 15] It is well known that low birthweight is a common consequence of premature birth, and premature birth is a common complication in multiple births These infants are likely at a higher risk for ROP. Studies have reported conflicting findings regarding the ROP risk in twin or multiple births. Singletons had a significant risk developing advanced ROP of stage II and III than twins.[16] Two respropective studies, both reported no significant findings between multiparity and ROP risk. [19] this study compared twin 1 and twin 2, rather than singletons versus twins These disagreement in findings with small sample sizes and different study design may not be generalizable to the population of twins versus singletons in developing ROP. We aimed to evaluate the ROP risk in the cohort of one of twins, comparing to singletons
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