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Antenatal Dexamethasone and Decreased Severity of Retinopathy of Prematurity

1998; American Medical Association; Volume: 116; Issue: 5 Linguagem: Inglês

10.1001/archopht.116.5.601

1538-3601

Rosemary D. Higgins,

Neonatal and fetal brain pathology

To assess risk factors associated with the development of retinopathy of prematurity (ROP) in an urban population.Observational cohort study.Bellevue Hospital Center, a regional perinatal referral center in New York City.Surviving inborn infants with birth weight less than 1250 g undergoing an ophthalmologic screening examination.Screening examination results for ROP were obtained. Additional data included birth weight, gestational age, maternal factors, and common neonatal diagnoses and exposures.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).Antenatal dexamethasone administration appears to be associated with a decreased incidence of development of ROP of stage 2 or higher in this urban population.