A newborn with unilateral limb enlargement.

On routine neonatal examination, a newborn term male was noted to have unilateral enlargement of the right lower limb, loose thickened red skin over the palm and widening of all the fingers on the right hand. His body was pinker and warmer on the right side compared with the left and he had a right undescended testicle and hypoplastic scrotum. Radiological examination of the lower limbs demonstrated the enlargement of the soft tissue of the right lower limb compared to the left (Fig. 1). Therefore, the diagnosis was unclear from this constellation of findings and an ophthalmic assessment was requested.

Is artificial reproductive technology a risk factor for retinopathy of prematurity independent of the generation of multiple births?

PURPOSE: There is some debate regarding whether artificial reproductive technology (ART) constitutes an independent risk factor for retinopathy of prematurity (ROP). We wanted to assess the prevalence of ART in multiple birth infants seen for ROP screening and whether or not ROP was identified or treated, in order to evaluate whether ART contributes a risk factor for ROP independent of the generation of multiple births. METHODS: A retrospective audit was performed of all multiple birth babies admitted to a tertiary neonatal unit who met the UK ROP screening criteria (<32 weeks gestational age [GA] and/or <1,501 g birthweight [BW]). RESULTS: A total of 205 babies met our criteria, of whom 87.3% were twins. A total of 39.5% were born following ART. A total of 30.5% of the non-ART group developed ROP vs 34% of the ART group (p = 0.837). Stage 3 ROP developed in 5.1% of non-ART babies and 6% of ART babies. A total of 8.5% of non-ART babies and 10% of ART babies required treatment for ROP. Logistic regression demonstrated that ART was not independently associated with development of ROP. CONCLUSIONS: Artificial reproductive technology multiple birth babies make up a considerable proportion of the ROP screening burden and their number is likely to increase as ART is increasingly available and utilized. We found no significant difference between the numbers of babies developing ROP in the ART vs non-ART groups, but the numbers are small. The estimated odds of developing ROP are slightly higher in the ART babies, so our data do not rule out a possible association.