Association between delivery of small-for-gestational age neonate and long-term pediatric ophthalmic morbidity

Objective: To investigate whether delivery of small for gestational age (SGA) neonate poses a risk for subsequent long-term ophthalmic morbidity. Methods: In this population-based study, all deliveries between 1991 and 2014 were included. Congenital malformations and multiple gestations were excluded from the analysis. Offspring were defined as either SGA (weight below the 5th percentile for gestational age) or non-SGA. Comparison was performed regarding the incidence of long-term ophthalmic morbidity in a cohort of neonates who were born SGA and those who were not. Ophthalmic morbidity was documented during any encounter with the hospital for a period of up to 18 years after delivery. Ophthalmic morbidity included infections of the eye or the adnexa, inflammation of any cause requiring admission, visual disturbances, and other hospital admissions carrying an ICD-9 code of ophthalmic designation. A Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for ophthalmic morbidity During the study period, 243,682 deliveries met the inclusion criteria, of which 11,290 (4.63%) were defined as SGA. Results: During the follow-up period, SGA neonates had higher rates of ophthalmic-related hospitalizations (1.2% versus 1.0%; OR = 1.22, 95% CI 1.02–1.46; p = 0.026). In a Cox proportional hazards model, adjusted for confounders such as maternal age, gestational age at delivery, child birth year, low 5 min Apgar scores (< 7), gestational diabetes, maternal hypertensive disorders, placental abruption and placenta previa, SGA neonate was independently associated with subsequent long-term ophthalmic morbidity (adjusted HR = 1.22; 95% CI 1.02–1.47; p = 0.024). Conclusion: Delivery of an SGA neonate is an independent risk factor for long-term ophthalmic morbidity.