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Perinatal and neonatal risk factors for retinopathy of prematurity in very low birthweight, very preterm twins: a population-based study

Eye volume 38, pages 902–909 (2024)Cite this article

Subjects

Abstract

Objective

To determine the effect of perinatal and neonatal risk factors on retinopathy of prematurity (ROP) and to examine the association of fertility treatments on the risk for ROP in very low birth weight (VLBW) preterm twins.

Methods

The population-based observational study consisted of VLBW twins born at 24–29 weeks gestational age (GA). Data from the Israel national database (1995–2020) were applied. Univariate and multivariable logistic regression using the General Estimating Equation were used for assessment of risk factors.

Results

The study population comprised 4092 infants of whom 2374 (58%) were conceived following fertility treatments. ROP was diagnosed in 851 (20.8%) infants. The odds for ROP approximately doubled with each week decrease in GA: at 24 weeks, Odds Ratio (OR) 58.00 (95% confidence interval (CI) 31.83–105.68); 25 weeks, OR 25.88 (95% CI 16.76–39.96); 26 weeks, OR 12.69 (95% CI 8.84–18.22) compared to 29 weeks GA. Each decrease in one birthweight z-score was associated with 1.82-fold increased risk for ROP (OR, 1.82, 95% CI 1.59–2.08). Infertility treatments were not associated with ROP. Neonatal morbidities significantly associated with ROP were surgical necrotizing enterocolitis (NEC) (OR, 2.04, 95% CI 1.31–3.19); surgically treated patent ductus arteriosus (PDA) (OR, 1.63, 95% CI 1.12–2.37); sepsis (OR, 1.43, 95% CI 1.20–1.71) and bronchopulmonary dysplasia (OR, 1.52, 95% CI 1.22–1.90).

Conclusion

Among preterm VLBW twins, poor intrauterine growth and surgical interventions for NEC and PDA were associated with high odds for ROP. This study does not support an association of fertility treatments with increased risk for ROP.

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Funding

The Israel National VLBW infant database is partially funded by the Israel Ministry of Health and the Israel Center for Disease Control.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Rachel Shemesh, Tzipi Strauss, Liat Lerner-Geva, Brian Reichman & Tamara Wygnanski-Jaffe

  2. Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel

    Rachel Shemesh & Tamara Wygnanski-Jaffe

  3. Department of Neonatology, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Israel

    Tzipi Strauss

  4. Women and Children’s Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Inna Zaslavsky-Paltiel, Liat Lerner-Geva & Brian Reichman

  5. Assaf Harofeh Medical Center, Tzrifin, Israel

    Iris Morag

  6. Assuta Hospital, Ashdod, Israel

    Omer Globus

  7. Barzilai Medical Center, Ashkelon, Israel

    Shmuel Zangen

  8. Baruch Padeh Medical Center, Poriya, Israel

    Tatyana Smolkin

  9. Bikur Cholim Hospital, Jerusalem, Israel

    Yaron Nave

  10. Bnai Zion Medical Center, Haifa, Israel

    Arieh Riskin

  11. Carmel Medical Center, Haifa, Israel

    Karen Lavie-Nevo

  12. Chaim Sheba Medical Center, Ramat Gan, Israel

    Zipora Strauss

  13. Emek Medical Center, Afula, Israel

    Clari Felszer

  14. French Saint Vincent de Paul Hospital, Nazareth, Israel

    Hussam Omari

  15. Hadassah University Hospital-Ein Karem, Jerusalem, Israel

    Smadar Even Tov-Friedman

  16. Hadassah University Hospital-Har Hazofim, Jerusalem, Israel

    Smadar Even Tov-Friedman

  17. Hillel Yaffe Medical Center, Hadera, Israel

    Amit Hochberg

  18. Holy Family (Italian) Hospital, Nazareth, Israel

    Nizar Saad

  19. Kaplan Medical Center, Rehovot, Israel

    Calanit Hershkovich Shporen

  20. Laniado Hospital, Netanya, Israel

    Aryeh Simmonds

  21. Mayanei Hayeshua Medical Center, Bnei Brak, Israel

    Bernard Barzilay

  22. Meir Medical Center, Kfar Saba, Israel

    Sofia Bauer

  23. Rambam Medical Center, Haifa, Israel

    Amir Kugelman

  24. Rivka Ziv Medical Center, Safed, Israel

    Eric Shinwell

  25. Schneider Children’s Medical Center of Israel, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel

    Gil Klinger

  26. Scottish (EMMS) Hospital, Nazareth, Israel

    Yousif Nijim

  27. Shaare-Zedek Medical Center, Jerusalem, Israel

    Yaron Nave

  28. Soroka Medical Center, Beersheba, Israel

    Eilon Shani

  29. Sourasky Medical Center, Tel Aviv, Israel

    Dror Mandel

  30. Western Galilee Medical Center, Nahariya, Israel

    Vered Fleisher-Sheffer

  31. Wolfson Medical Center, Holon, Israel

    Anat Oron

  32. Yoseftal Hospital, Eilat, Israel

    Lev Bakhrakh

Authors
  1. Rachel Shemesh
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  2. Tzipi Strauss
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  3. Inna Zaslavsky-Paltiel
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  4. Liat Lerner-Geva
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  5. Brian Reichman
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  6. Tamara Wygnanski-Jaffe
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Consortia

in collaboration with the Israel Neonatal Network

  • Iris Morag
  • , Omer Globus
  • , Shmuel Zangen
  • , Tatyana Smolkin
  • , Yaron Nave
  • , Arieh Riskin
  • , Karen Lavie-Nevo
  • , Zipora Strauss
  • , Clari Felszer
  • , Hussam Omari
  • , Smadar Even Tov-Friedman
  • , Smadar Even Tov-Friedman
  • , Amit Hochberg
  • , Nizar Saad
  • , Calanit Hershkovich Shporen
  • , Aryeh Simmonds
  • , Bernard Barzilay
  • , Sofia Bauer
  • , Amir Kugelman
  • , Eric Shinwell
  • , Gil Klinger
  • , Yousif Nijim
  • , Yaron Nave
  • , Eilon Shani
  • , Dror Mandel
  • , Vered Fleisher-Sheffer
  • , Anat Oron
  •  & Lev Bakhrakh

Contributions

RS cleaned and analysed the data and drafted and revised the paper, TS collected the data and revised the paper, IZP wrote the statistical analysis plan and analysed the data and revised the paper, LLG analysed the data and revised the paper, BR cleaned and analysed the data, wrote the statistical analysis plan and revised the paper, TWJ initiated the project, collected and analysed the data, and revised the paper.

Corresponding author

Correspondence to Tamara Wygnanski-Jaffe.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

This study was conducted in accordance with prevailing ethical principles and approved by the Human Research Committee of the Sheba Medical Center (SMC-9443-22).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

The Israel Neonatal Network, which compiles the Israel national VLBW infant database, consists of these participating centers: Assaf Harofeh Medical Center, Rishon Le Zion; Assuta Hospital, Ashdod; Barzilay Medical Center, Ashkelon; Bikur Holim Hospital, Jerusalem; Bnei Zion Medical Center, Haifa; Carmel Medical Center, Haifa; English (Scottish) Hospital, Nazareth; French Hospital, Nazareth; Hadassah University Hospital Ein-Karem, Jerusalem; Hadassa University Hospital Har Hazofim, Jerusalem; Haemek Medical Center, Afula; Hillel Yafe Medical Center, Hadera; Italian Hospital, Nazareth; Kaplan Hospital, Rehovot; Laniado Hospital, Netanya; Maayanei Hayeshua Medical Center, Bnei-Brak; Meir Medical Center, Kefar Saba; Misgav Ladach Hospital, Jerusalem; Poriah Hospital, Tiberias; Rambam Medical Center, Haifa; Rivka Ziv Hospital, Zefat; Schneider Children’s Medical Center of Israel and Rabin Medical Center (Beilinson Campus), Petach- Tikva; Shaare-Zedek Hospital, Jerusalem; Sheba Medical Center, Tel-Hashomer; Soroka Medical Center, Beer-Sheva; Sourasky Medical Center, Tel-Aviv; Western Galilee Medical Center, Nahariya; Wolfson Medical Center, Holon; Yoseftal Hospital, Eilat; Coordinating center, The Women and Children’s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer.

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Shemesh, R., Strauss, T., Zaslavsky-Paltiel, I. et al. Perinatal and neonatal risk factors for retinopathy of prematurity in very low birthweight, very preterm twins: a population-based study. Eye 38, 902–909 (2024). https://doi.org/10.1038/s41433-023-02801-8

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