Antenatal dexamethasone and decreased severity of retinopathy of prematurity

Abstract

Objective: To assess risk factors associated with the development of retinopathy of prematurity (ROP) in an urban population. Design: Observational cohort study. Setting: Bellevue Hospital Center, a regional perinatal referral center in New York City. Patients: Surviving inborn infants with birth weight less than 1250 g undergoing an ophthalmologic screening examination. Main Outcome Measures: Screening examination results for ROP were obtained. Additional data included birth weight, gestational age, maternal factors, and common neonatal diagnoses and exposures. Results: Sixty-three infants were included in the analysis. Mean±SD birth weight was 981 ± 179 g and mean gestational age was 27.8 ± 2.4 weeks. Infants whose mothers received antenatal dexamethasone developed significantly less ROP that was stage 2 or higher than infants without a history of antenatal dexamethasone exposure 8.7% (2/23) vs 35% (14/40), respectively (P=.04). Birth weight, gestational age, respiratory distress syndrome, bronchopulmonary dysplasia, and patent ductus arteriosus were also significantly associated with the development of ROP that was stage 2 or higher. After controlling for these confounders by multiple logistic regression analysis, antenatal dexamethasone administration was associated with a significantly decreased risk of development of ROP stage 2 or higher(adjusted odds ratio [OR], 0.14; 95% confidence interval [CI], 0.02- 0.93). The association was stronger when the analysis was restricted to the 36 infants who were 24 to 28 weeks of gestational age (adjusted OR, 0.02; 95% CI, 0.00-0.76). Conclusion: Antenatal dexamethasone administration appears to be associated with a decreased incidence of development of ROP of stage 2 or higher in this urban population.