Insights into Risk: Exploring Retinopathy of Prematurity and Short-term Comorbidities in Moderate-to-Late Preterm Infants.

BACKGROUND: Retinopathy of prematurity (ROP) and short-term comorbidity data moderate-to-late preterm (MLP) infants in Saudi Arabia are limited. AIM: The present study mainly aimed to identify ROP incidence and severity in MLP infants. The secondary objective was to explore whether moderate preterm infants are more prone to systemic short-term comorbidities compared to late preterm infants. MATERIALS AND METHODS: This retrospective study was conducted at King Abdulaziz University Hospital, a tertiary center in Jeddah, Saudi Arabia. Two-hundred and sixty-eight MLP infants born with gestational ages (GAs) of 32 to 36 + 6 weeks were included. Births were classified as moderate preterm (GA 32 to 33 + 6 weeks) and late preterm (GA 34 to 36 + 6 weeks) and the two groups were compared with an independent t-test. RESULTS: ROP incidence was 1.5%; all cases were stage 1 and involved zone II or III. No patient had type 1 ROP requiring treatment. The short-term comorbidity incidence was high (76.1%) and included hyperbilirubinemia (n = 206, 76.7%), respiratory distress syndrome (n = 178, 66.4%), hypoglycemia (n = 32, 11.9%,), and transient tachypnea of newborn (n = 25, 9.3%). Moderate preterm infants were more likely to have lower birth weight (P < 0.001), any-stage ROP (P = 0.032), respiratory distress syndrome (P = 0.031), intraventricular hemorrhage (P = 0.038), and hyperbilirubinemia (P < 0.001) compared to the late preterm infants. CONCLUSIONS: Any-stage ROP incidence among MLP infants was low, with no type 1 ROP cases requiring treatment. Short-term comorbidity incidence was relatively high among the moderate preterm infants. Despite the low non-type 1 ROP incidence at our center, MLP infants require proper surveillance of systemic short-term comorbidities.

Retrospective validation of the postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria in a developing country.

Background: The characteristics of premature infants vary from country to country rendering it challenging to apply retinopathy of prematurity (ROP) screening algorithm globally. The screening criteria for postnatal growth and ROP (G-ROP) for preterm infants are known to be beneficial, but it is not clear whether these criteria can be used universally. Aim: The aim of this study is to validate the accuracy of the G-ROP criteria in screening preterm infants in Saudi Arabia. Subjects and Methods: This single-center retrospective study included 300 premature infants (mean gestational age [GA], 28.72 ± 2.2 weeks; range, 21-36 weeks) at a referral center who were screened for ROP between 2015 and 2021. The inclusion criteria were the availability of data on ROP outcome and body weight up until day 40 after birth. The G-ROP 1 and G-ROP 2 models were examined for their ability and accuracy in identifying infants with any stage ROP and treatable ROP. Results: The G-ROP 1 and G-ROP 2 models identified 233 and 255 infants for screening, respectively. The sensitivity of G-ROP 1 and G-ROP 2 for detecting treated ROP was 96.7% and 100%, respectively, and the specificity for detecting treatable ROP was 24.4% and 16.7%, respectively. Incorporation of the G-ROP 2 model, which did not miss any infant with type 1 ROP, would have reduced the number of screened infants by 15%. Conclusion: G-ROP 2 was more sensitive than G-ROP 1 for identifying infants who required treatment and could potentially reduce the burden of ROP screening.

The impact of moderate-to-late prematurity on ocular structures and visual function in Saudi children.

AIM: To assess and compare ophthalmologic and morphologic outcomes between school-age children born moderate-to-late preterm and those born at term. PATIENTS AND METHODS: Fifty children born moderate-to-late preterm (gestational age 32 weeks + 0 days to 36 + 6 days, age range 5-10 years) at a tertiary university hospital were age- and sex-matched to full-term controls. Visual acuity, refractive errors, ocular biometry, macular, and optic nerve assessments with optical coherence tomography were investigated and compared between cases and controls. RESULTS: No differences in visual acuity or refraction were detected between the study groups. The difference in refractive error was not significant between the groups. Marked differences were observed in the anterior chamber depth, which was shallower in the preterm group (P = 0.044); however, no difference in total axial length was observed. The preterm and control groups significantly differed in terms of central macular thickness (247 ± 19 µm versus 235 ± 22 µm; P = 0.005 right eye); however, the groups did not significantly differ in foveal thickness. Central subfield thickness was also markedly greater in the preterm than in the control children (246.89 ± 19.1 µm versus 236.12 ± 23.3 µm, P = 0.015). No significant differences in mean parafoveal/perifoveal thicknesses or optic nerve parameters were observed between both groups. CONCLUSION: Significant differences between moderate to late preterm and full-term groups in regards to anterior chamber depth, central macular thickness, and central subfield thickness were found. It is important to recognize that being born preterm might have an impact on some ocular structures. Larger population-based studies should be conducted to study the long-term sequelae of moderate-to-late prematurity in our children.