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Acta Paediatr. 2018 May;107(5):811-821. doi: 10.1111/apa.14206. Epub 2018 Jan 18.

Extreme prematurity, treated retinopathy, bronchopulmonary dysplasia and cerebral palsy are significant risk factors for ophthalmological abnormalities at 6.5 years of age.

Author information

1
Section of Pediatric Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
2
Centre of Reproductive Epidemiology, Lund University, Lund, Sweden.
3
Department of Ophthalmology, Örebro University, Örebro, Sweden.
4
Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden.
5
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
6
Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden.
7
Department of Women's and Children's Health, Section for Pediatrics, Uppsala University, Uppsala, Sweden.
8
Department of Psychology, Lund University, Lund, Sweden.
9
Department of Ophthalmology, Lund University Hospital, Lund, Sweden.
10
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Abstract

AIM:

This study evaluated the contributions of various prenatal and postnatal predictive factors to a documented high prevalence of ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm.

METHODS:

We carried out a prospective population-based study of all children born in Sweden at a gestational age of 22 + 0 to 26 + 6 weeks based on the Extremely Preterm Infants in Sweden Study. The main outcome measures were a combined score of visual impairment, refractive errors and strabismus at 6.5 years of age. Models of univariate and multivariable regression were used to analyse potential prenatal and postnatal predictive factors at different clinically relevant time-points from one minute after birth to 30 months.

RESULTS:

We focused on 399 known extremely preterm survivors and compared them to 300 full-term controls. Significant antecedents for ophthalmological abnormalities included prematurity per se, retinopathy of prematurity that required treatment, severe bronchopulmonary dysplasia and cerebral palsy. Severe intraventricular haemorrhage was no longer a significant risk factor when we adjusted it for the 30-month cognitive and neuromotor development outcomes.

CONCLUSION:

This time-course risk analysis model showed a changing panorama of significant risk factors for ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm.

KEYWORDS:

Bronchopulmonary dysplasia; Intraventricular haemorrhage; Ophthalmological outcome; Perinatal risk factors; Retinopathy of prematurity

PMID:
29281748
DOI:
10.1111/apa.14206

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