Risk of long-term ophthalmological complications in Taiwanese preterm infants: a nationwide cohort study

Chia-Yu Huang; Sio-Ian Tou; Heng-Jun Lin; Hung-Rong Yen

doi:10.1136/bmjpo-2023-002279

Risk of long-term ophthalmological complications in Taiwanese preterm infants: a nationwide cohort study

BMJ Paediatr Open. 2024 Nov 28;8(1):e002279. doi: 10.1136/bmjpo-2023-002279.

Authors

Chia-Yu Huang^{1

2}, Sio-Ian Tou³, Heng-Jun Lin^{4

5}, Hung-Rong Yen^{6

7

8

9

10}

Affiliations

¹ Department of Family Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
² Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
³ Department of Pediatrics, Chung Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan.
⁴ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁵ College of Medicine, China Medical University, Taichung, Taiwan.
⁶ Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan hungrongyen@mail.cmu.edu.tw.
⁷ Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
⁸ Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
⁹ International Master Program in Acupuncture, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
¹⁰ Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.

Abstract

Objectives: The aim was to determine whether different maturity levels and birth weights could change the risk of long-term ophthalmological complications in preterm infants.

Design: This was a cohort study.

Setting: This was a nationwide population-based study.

Participants: Newborns born between 2009 and 2012 were identified; newborns with congenital deformities, newborns with missing data on urban area, sex, gestational week at birth or birth weight and newborns who died before the age of 8 years were excluded.

Interventions: Infants were divided into full-term, preterm and preterm with retinopathy of prematurity (ROP) cohorts based on their basic characteristics at birth.

Primary outcome measures: The primary outcomes were ophthalmological complications, including strabismus, refractive error, amblyopia, cataracts and glaucoma.

Results: Ultimately, 735 702 infants were included in the analysis. There were 727 403, 7165 and 1134 newborns in the full term, preterm without ROP and preterm with ROP cohorts, respectively. Premature infants, whether without ROP or with ROP, had an elevated risk of various ophthalmic complications, with adjusted ORs (aORs) ranging from 1.48 to 2.74 and 1.90 to 10.34, respectively. Extremely low birth weight contributes to an increased risk of various ophthalmic complications, with aORs ranging from 2.21 to 6.55. Moreover, a higher number of negative variables, such as preterm birth or low body weight, increased the risk of various ophthalmological complications, with the aOR falling within the range of 1.03-23.86.

Conclusions: Immaturity and low body weight were risk factors for ophthalmological complications in preterm infants. The presence of both of these two risk factors increased the risk of ophthalmological complications. Our results are essential for caregivers and health policy-makers to design comprehensive follow-up plans for preterm infants.

Keywords: Neonatology; Ophthalmology.

MeSH terms

Birth Weight
Cohort Studies
Eye Diseases / epidemiology
Eye Diseases / etiology
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature*
Male
Retinopathy of Prematurity* / epidemiology
Risk Factors
Taiwan / epidemiology