Objective: To investigate the role of singleton or multiple pregnancies in the development of retinopathy of prematurity (ROP) in late preterm infants. Material and Methods: The findings of preterm infants born at 32-35 weeks of gestation and without any perinatal risk factors were retrospectively evaluated. The relationship between risk factors and development of ROP was analyzed using logistic regression analysis. Results: Of the 2,364 preterm infants, 1,160 (49.07%) were singleton pregnancies and 1,204 (50.93%) were multiple pregnancies. ROP was detected in 3.13% (n=74) of the infants; 0.85% (n=20) of these were singleton pregnancies and 2.28% (n=54) were multiple pregnancies. ROP development was significantly higher in infants with a multiple pregnancy history (p=0.000), and gestational age (GA) and birth weight (BW) were significantly lower (p=0.000, p=0.003). While there was no significant relationship between gender and the development of ROP in univariate analysis, GA, BW, postmenstruel age at examination and multiple pregnancy were significantly associated with ROP (β=0.436, p=0.000; β=0.998, p=0.000; β=0.637, p=0.000; β=2.677, p=0.000, respectively). In multivariable analysis, GA (β=0.554, p=0.000), BW (β=0.999, p=0.001) and multiple pregnancy (β=2.375, p=0.001) were significantly associated with the development of ROP. Conclusion: In conclusion, this study supports that multiple pregnancies may cause preterm birth and low BW in late preterm infants and may play a role in the development of ROP. Therefore, it may be appropriate to examine late preterm infants for ROP at least once, especially in developing countries.
Keywords: Retinopathy of prematurity; singleton pregnancy; multiple pregnancy; late preterm infant
Amaç: Geç prematüre bebeklerde prematüre retinopatisi (PR) gelişiminde tekil veya çoğul gebeliklerin rolünün araştırılması. Gereç ve Yöntemler: PR nedeniyle takip edilen, 32-35. gebelik haftaları arasında doğan ve herhangi bir perinatal risk faktörü olmayan yenidoğanların muayene bulguları geriye dönük değerlendirildi. PR gelişimi ile risk faktörleri arasındaki ilişki lojistik regresyon analizi kullanılarak analiz edildi. Bulgular: Çalışmaya dâhil edilen 2.364 yenidoğanın 1.160'ında (%49,07) tekil gebelik, 1.204'ünde (%50,93) çoğul gebelik öyküsü mevcuttu. Yenidoğanların %3,13'ünde (n=74) PR tespit edilmiş olup %0,85'inde (n=20) tekil gebelik, %2,28'inde (n=54) çoğul gebelik saptandı. Çoğul gebelik öyküsü olan bebeklerde tekil gebelik öyküsü olanlara göre PR gelişimi anlamlı olarak daha yüksek (p=0,000), gebelik yaşı (GY) ve doğum ağırlığı (DA) anlamlı olarak daha düşük idi (p=0,000, p=0,003). Tek değişkenli regresyon analizinde cinsiyet ile PR gelişimi arasında anlamlı bir ilişki bulunmazken, GY, DA, postmenstrüel muayene yaşı ve çoğul gebelik PR ile anlamlı düzeyde ilişkiliydi (sırasıyla β=0,436, p=0,000; β=0,998, p=0,000; β=0,637, p=0,000; β=2,677, p=0,000). Çok değişkenli regresyon analizinde ise GY (β=0,554, p=0,000), DA (β=0,999, p=0,001) ve çoğul gebelik (β=2,375, p=0,001) ile PR gelişimi arasındaki anlamlı ilişkinin devam ettiği gözlendi. Sonuç: Sonuç olarak, bu çalışma çoğul gebeliklerin geç preterm bebeklerde erken doğuma ve düşük doğum ağırlığına neden olabileceğini ve PR gelişiminde rol oynayabileceğini desteklemektedir. Bu nedenle özellikle gelişmekte olan ülkelerde geç prematüre bebeklerin en az bir kez PR açısından taranması uygun olabilir.
Anahtar Kelimeler: Prematüre retinopatisi; tekil gebelik; çoğul gebelik; geç preterm yenidoğan
- Parchand SM, Gangwe A, Agrawal D. Commentary: retinopathy of prematurity: where do we stand? Indian J Ophthalmol. 2021;69(8):2132-3. [Crossref] [PubMed] [PMC]
- Tseng HC, Sung FC, Mou CH, Lin HY, Chiang CC, Hsia NY, et al. Population based retrospective cohort study on risk of retinopathy of prematurity in twins. PLoS One. 2020;15(3):e0230346. [Crossref] [PubMed] [PMC]
- Gao X, Liao Y, Lin D, Wang L, Yu D, Li Z, et al. Incidence and characteristics of retinopathy of prematurity patients with late gestational age and large birth weight in South China. Front Med (Lausanne). 2022;9:712759. [Crossref] [PubMed] [PMC]
- Dericioğlu V, Butur S, Celiker H, Şahin Ö. Incidence, risk factors and screening evaluation of retinopathy of prematurity in high birthweight infants: a large cohort study in Turkey. Ophthalmic Epidemiol. 2022;29(1):78-84. [Crossref] [PubMed]
- Çömez A, Çelemler P, Özmen MC, Yurttutan S, Akkececi NS, Güngör K, et al. Retinopathy of prematurity incidence and treatment modalities in moderate and late preterm infants: a study from two tertiary centers. Can J Ophthalmol. 2022;57(3):195-200. [Crossref] [PubMed]
- Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018;63(5):618-37. [Crossref] [PubMed] [PMC]
- Yu CW, Popovic MM, Dhoot AS, Arjmand P, Muni RH, Tehrani NN, et al. Demographic risk factors of retinopathy of prematurity: a systematic review of population-based studies. Neonatology. 2022;119(2):151-63. [Crossref] [PubMed]
- Wikstrand MH, Hård AL, Niklasson A, Smith L, Löfqvist C, Hellström A. Maternal and neonatal factors associated with poor early weight gain and later retinopathy of prematurity. Acta Paediatr. 2011;100(12):1528-33. [Crossref] [PubMed]
- Uchida A, Miwa M, Shinoda H, Koto T, Nagai N, Mochimaru H, et al. Association of maternal age to development and progression of retinopathy of prematurity in infants of gestational age under 33 weeks. J Ophthalmol. 2014;2014:187929. [Crossref] [PubMed] [PMC]
- Wu WC, Ong FS, Kuo JZ, Lai CC, Wang NC, Chen KJ, et al. Retinopathy of prematurity and maternal age. Retina. 2010;30(2):327-31. [Crossref] [PubMed] [PMC]
- Riazi-Esfahani M, Alizadeh Y, Karkhaneh R, Mansouri MR, Kadivar M, Nili Ahmadabadi M, et al. Retinopathy of prematurity: single versus multiple-birth pregnancies. J Ophthalmic Vis Res. 2008;3(1):47-51. [PubMed] [PMC]
- Dabir S, Mohankumar A, Srivatsa DV, Munusamy S, Berendschot TTJ, Rajan M, et al. Retinopathy of prematurity in preterm infants born following assisted conception versus spontaneously conceived pregnancies - A 2-year retrospective observational study from an urban tertiary eye care referral center in South India. Indian J Ophthalmol. 2023;71(2):408-10. [Crossref] [PubMed] [PMC]
- Blumenfeld LC, Siatkowski RM, Johnson RA, Feuer WJ, Flynn JT. Retinopathy of prematurity in multiple-gestation pregnancies. Am J Ophthalmol. 1998;125(2):197-203. [Crossref] [PubMed]
- Friling R, Rosen SD, Monos T, Karplus M, Yassur Y. Retinopathy of prematurity in multiple-gestation, very low birth weight infants. J Pediatr Ophthalmol Strabismus. 1997;34(2):96-100. [Crossref] [PubMed]
- Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Paul Chan RV, Berrocal A, et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology. 2021;128(10):e51-e68. [PubMed]
- Alsammahi A, Basheikh A. Retinopathy of prematurity and assisted reproductive technology: is there an association? Clin Ophthalmol. 2021;15:227-33. [Crossref] [PubMed] [PMC]
- Friling R, Axer-Siegel R, Hersocovici Z, Weinberger D, Sirota L, Snir M. Retinopathy of prematurity in assisted versus natural conception and singleton versus multiple births. Ophthalmology. 2007;114(2):321-4. [Crossref] [PubMed]
- Blondel B, Kogan MD, Alexander GR, Dattani N, Kramer MS, Macfarlane A, et al. The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: an international study. Am J Public Health. 2002;92(8):1323-30. [Crossref] [PubMed] [PMC]
- Tiryaki Demir S, Karapapak M, Uslu HS, Bulbul A, Guven D, Dirim AB, et al. Retinopathy screening results of late-preterm infants born at 32-35 weeks of gestational age. Graefes Arch Clin Exp Ophthalmol. 2019;257(6):1325-9. [Crossref] [PubMed]
- Yildiz Ekinci D, Ugurlu A, Tasli NG. What is the incidence of retinopathy of prematurity (ROP) in 'big' babies?: Results of a retrospective multicenter study. Ophthalmic Epidemiol. 2021;28(2):138-43. [Crossref] [PubMed]
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