Early term deliveries and long term pediatric ophthalmic morbidity

Atar Ben-shmuel, Eyal Sheiner, Tamar Wainstock, Erez Tsumi, Danielle Landau, Asnat Walfisch

Research output: Contribution to journalMeeting Abstract

Abstract

Objective
Prematurity is a known risk factor for short and long term ophthalmic morbidity. We examined whether early term delivery impacts long term ophthalmic health of the offspring.

Study Design
A retrospective population based cohort study was conducted, including all singleton deliveries between January 1991 and December 2013 occurring at a single regional tertiary medical center. Gestational age at delivery was sub-divided into: Early prematurity (24 o/7-33 6/7 weeks’ gestation), late prematurity (34 0/7-36 6/7), early term (37 0/7-38 6/7), full term (39 0/7-40 6/7), late term (41 0/7-41 6/7) and post term (≥42 0/7 weeks). Hospitalization of offspring up to 18 years of age, involving ophthalmic morbidity were evaluated. This included infectious/inflammatory diseases, retinopathy of prematurity, visual disturbances, and “other”. Kaplan-Meier survival curves were used to compare cumulative hospitalization incidences and a Cox hazards regression model to control for confounders.

Results
During the study period, 242,187 deliveries met the inclusion criteria. Ophthalmic related hospitalization rate of offspring were lower among early term born children (1.0%) as compared with early (2.2%) and late (1.3%) preterm born children, but higher than in offspring born at full (0.9%), late (0.8%) and post (0.8%) term (p< 0.001). The survival curve demonstrated significantly different cumulative hospitalization rates in the different gestational age groups (Log rank p< 0.001; Figure). A cox regression analysis demonstrated a significant and independent increased risk for ophthalmic morbidity among early term born offspring (adjusted Hazard ratio 1.11, CI 1-1.23, p< 0.05; Table), while late and post term deliveries were associated with a lower risk (aHR 0.79 and 0.82 respectively, Table) as compared to full term deliveries.

Conclusion
The risk for long term ophthalmic related hospitalizations of offspring gradually declines as gestational age at birth advances. Early term born offspring carry a higher risk as compared to those born at a later gestational age.
Original languageEnglish GB
Pages (from-to)S195-S196
JournalAmerican Journal of Obstetrics and Gynecology
Volume222
Issue number1
DOIs
StatePublished - Jan 2020

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