Abstract
ObjectiveThis study aimed to investigate whether severe retinopathy of prematurity (ROP) could be an association factor for neurodevelopmental disorders in premature infants without other risk factors—such as congenital anomalies, birth injuries, and neurological diseases—that may cause developmental delay.MethodsWe used health claims data recorded between 2007 and 2018 in the Korean National Health Insurance Service (KNHIS) database. We recruited a total of 18,256 premature infant born between 2007 and 2008 without congenital anomaly or birth injury (with ROP 6,995, without ROP 11,261) and divided them into four groups as follows: Group A, 209 extremely premature infants [gestational age (GA) < 28] with mild ROP; Group B, 75 extremely premature infants (GA < 28) with severe ROP; Group C, 6,510 other premature infants (28 ≤ GA <37)with mild ROP; and Group D, 201 other premature infants (28 ≤ GA < 37) with severe ROP. Using regression analysis, we analyzed whether there was a correlation between ROP prevalence, severity, and developmental delay in premature infants without other risk factors.ResultsThe prevalence of developmental delay, according to GA and ROP severity, was higher in patients with severe ROP than in the other patients. The prevalence gradually decreased after birth. Among extremely premature infants with ROP, those with severe ROP had a 3.082-fold higher association with neurodevelopmental complications than those with mild ROP (p < 0.001). Compared with other premature infants with ROP, those with severe ROP had a 3.269-fold higher association with neurodevelopmental complications than those with mild ROP.ConclusionThe severity of ROP may be associated with neurodevelopmental disorders in premature infants.
Highlights
The birth rate of premature infants has been steadily increasing in South Korea; owing to the medical development of the neonatal intensive care unit (NICU), their survival has increased [1,2,3,4]
This study aimed to investigate whether severe retinopathy of prematurity (ROP) could be an association factor for neurodevelopmental disorders in premature infants without other risk factors—such as congenital anomalies, birth injuries, and neurological diseases—that may cause developmental delay
The severity of Retinopathy of prematurity (ROP) may be associated with neurodevelopmental disorders in premature infants
Summary
The birth rate of premature infants has been steadily increasing in South Korea; owing to the medical development of the neonatal intensive care unit (NICU), their survival has increased [1,2,3,4]. Detection of neurodevelopmental delay in premature infants is important because early diagnosis and appropriate treatment can improve the patients’ condition or alleviate their symptoms [4, 7]. The early identification of risk factors by conducting intensive developmental screening tests is imperative to classify high-risk groups for developmental delay [6, 8, 9]. As the incidence of premature births and low birth weight in newborns increases, the overall risk of ROP increases [13, 14]. Recent studies have focused on the correlation between extraocular and neurodevelopmental complications, while previous studies have investigated the developmental and maturity status of the brain through imaging screening at a point in time [13, 16,17,18]
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