357 - Are patients with bronchopulmonary dysplasia at higher risk for severe retinopathy of prematurity?

Poster Number: 357
Publication Number: 357.440

Kim chi T. Bui, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA, United States; Qiaoling Chen, Kaiser Permanente Southern California, Pasadena, CA, United States; Naomi Ellenhorn, Southern California Permanente Medical Group, Los Angeles, CA, United States; Afshan Abbasi, Kaiser Permanente, Downey, CA, United States; Maria Fe B. B. Villosis, Kaiser Permanente Southern California Medical Group, Panorama City, CA, United States

Background: Retinopathy of prematurity (ROP) is a developmental retinal vascular disease and a major cause of blindness in children born prematurely. Identified risk factors for ROP include low gestational age (GA), low birthweight (BW), neonatal infections, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), and pulmonary disease with oxygen requirement.

Objective: This study's objective was to evaluate whether preterm infants with bronchopulmonary dysplasia (BPD), defined as oxygen requirement at 36 weeks postmenstrual age, were at increased risk for severe ROP compared to infants without BPD.

Design/Methods: Secondary analysis was performed on data from two prior retrospective cohort studies on risk factors for BPD and for ROP in preterm infants of 23 to 32 weeks GA, born between 2009 and 2014 with birthweights 1500 grams or less. A propensity score analysis using an inverse probability of treatment weighting approach was used to examine the association between BPD and ROP stage 2 and higher, or ROP needing treatment.

Results: The cohort consisted of 1,762 infants, of whom 402 (22.8%) had BPD. For the unweighted sample, the incidence of ROP stage 2 and above was higher in BPD patients compared to non -BPD (50% versus 14%, P value < .001). After propensity score analysis with adjustments for other risk factors for ROP, the association between BPD and ROP showed a trend where BPD patients were more likely to have ROP stage 2 and above, but this was not statistically significant (OR 1.43,95% CI: 0.93-2.19) for the whole cohort or for the subgroup of infants born at < 28 weeks GA (OR 1.47, 95%CI:0.93-2.32). BPD was not associated with ROP needing treatment either in the whole cohort (OR 1.31, 95% CI: 0.77-2.24) or the subgroup of preterm infants born at < 28 weeks GA (OR 1.19, 95% CI: 0.72-1.98).Conclusion(s): The incidence of ROP stage 2 and above was higher in BPD patients. However, after adjustment for other risk factors for ROP, the association between BPD and  ROP stage 2 and above did not reach statistical significance. BPD was not associated with severe ROP needing treatment.
Outcome by BPD status of the weighted sample
Highest stages of ROP distribution in the unweighted and weighted samples