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Developmental outcome in preterm infants <29 weeks gestation with ⩽ Stage 3 retinopathy of prematurity (ROP): relationship to severity of ROP

  • D.A. Todd (a1), T-A. Goyen (a2), J. Smith (a3) and M. Rochefort (a2)

We have determined the influence of the severity of retinopathy of prematurity (ROP) on development at 3 years of age in infants <29 weeks gestation from a population-based cohort. Primary analysis of surviving infants born <29 weeks gestational age (GA) from 1998 to 2001 in New South Wales and the Australian Capital Territory were grouped according to stage of ROP. Infants with periventricular leukomalacia, Grade III or IV intraventricular haemorrhage, hydrocephalus, major congenital abnormalities, Stage 4 or 5 ROP, cerebral palsy or a severe hearing impairment were excluded. Infants with Stage 3 ROP were matched for GA, birthweight and gender to those with no ROP, Stage 1 and Stage 2 ROP. The four groups were then compared for their 3-year-old developmental outcome, using the Griffiths Mental Development Scale. Development was also compared for those infants with Stage 3 ROP who were either treated or not treated with laser therapy. A secondary multivariate regression analysis on developmental outcome was performed with all infants included in the analysis. In neurologically comparable groups and in the multivariate analysis, there was no association between ROP and developmental outcome. There was also no difference in the Griffiths assessment at 3 years between those who were or were not treated for severe ROP. Neither severity of ROP nor treatment for severe ROP were related to developmental outcome at 3 years of age in a large population-based cohort of infants born <29 weeks gestation.

Corresponding author
*Address for correspondence: Dr D.A. Todd, Centre for Newborn Care, Canberra Hospital, Woden ACT 2606, Australia. (Email
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1. Vohr, BR, Wright, LL, Dusick, AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993–1994. Pediatrics. 2000; 105, 12161226.
2. O'Callaghan, MJ, Burns, Y, Gray, P, et al. Extremely low birth weight and control infants at 2 years corrected age: a comparison of intellectual abilities, motor performance, growth and health. Early Hum Dev. 1995; 40, 1 15128.
3. Saigal, S, Szatmari, P, Rosenbaum, P, et al. Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: a regional study. J Pediatr. 1991; 118, 751760.
4. Shapiro, A, Yanko, L, Nawratzki, I, Merin, S. Refractive power of premature children at infancy and early childhood. Am J Ophthalmol. 1980; 90, 234238.
5. Kushner, BJ. Strabismus and amblyopia associated with regressed retinopathy of prematurity. Arch Ophthalmol. 1982; 100, 256261.
6. Nissenkorn, I, Yassur, Y, Mashkowski, D. Myopia in premature babies with and without retinopathy of prematurity. Br J Ophthalmol. 1983; 67, 170173.
7. Keith, CG. Visual outcome and effect of treatment in Stage 3 developing retrolental fibroplasia. Opthalmology. 1982; 66, 446449.
8. Keith, CG, Kitchen, WH. Ocular morbidity in infants of very low birth weight. Br J Opthalmol. 1983; 67, 302305.
9. International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005; 123, 991999.
10. Griffiths, R. The Abilities of Young Children. A Comprehensive System of Mental Measurement for the First Eight Years of Life, 1970. The Test Agency: High Wycombe, UK.
11. Todd, DA, Wright, A, Byth, K, Smith, J, the NICUS Group. Severe retinopathy of prematurity in infants <30 weeks’ gestation in New South Wales and the Australian Capital Territory from 1992 to 2002. Arch Dis Child Fetal Neonatal Ed. 2007; 92, F251F254.
12. Pennefeather, PM, Clarke, MP, Strong, NP, et al. Risk factors for strabismus in children born before 32 weeks’ gestation. Br J Ophthalmol. 1999; 83, 514518.
13. Larsson, E, Rydberg, A, Holmström, G. Contrast sensitivity in 10 year old preterm and full term children: a population based study. Br J Ophthalmol. 2006; 90, 8790.
14. Ricci, B. Refractive errors and ocular motility disorders in preterm babies with and without retinopathy of prematurity. Ophthalmologica. 1999; 213, 295299.
15. Goyen, T-A, Todd, DA, Veddovi, M, et al. Eye–hand coordination skills at 3 years in preterm infants: effect of preterm birth and retinopathy of prematurity. Early Hum Dev. 2006; 82, 739745.
16. Bowen, JR, Starte, DR, Arnold, JD, et al. Extremely low birth-weight infants at 3 years: a developmental profile. J Paediatr Child Health. 1993; 29, 276281.
17. Sampath, V, Bowen, J, Gibson, F. Risk factors for adverse neurodevelopment in extremely low birth weight infants with normal neonatal cranial ultrasound. J Perinatol. 2005; 25, 210215.
18. Msall, ME, Phelps, DL, DiGaudios, KM, et al. . on Behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Severity of retinopathy of prematurity is predictive of neurodevelopmental functional outcome at age 5.5 years. Pediatrics. 2000; 106, 9981005.
19. Cunningham, S, Fleck, BW, Elton, RA, McIntosh, N. Transcutaneous oxygen levels in retinopathy of prematurity. Lancet. 1995; 346, 14641465.
20. Kennedy, J, Todd, DA, Watts, J, John, E. Retinopathy of prematurity (ROP) in infants <29 weeks gestation: 3.5 pre and post surfactant. J Pediatr Ophthalmol Strabismus. 1997; 34, 289292.
21. Todd, DA, Kennedy, J, Roberts, S, et al. Retinopathy of prematurity in infants less than 29 weeks’ gestation at birth. Aust N Z J Ophthalmol. 1994; 22, 1923.
22. John, E, Todd, DA. Patent ductus arteriosus and retinopathy of prematurity in infants below 27 weeks gestation. Aust Paediatr J. 1988; 24, 171173.
23. Jennische, M, Sedin, G. Speech and language skills in children who required neonatal intensive care: evaluation at 6.5 y of age based on interviews with parents. Acta Paediatr. 1999; 88, 975982.
24. Wolke, D, Samara, M, Bracewell, M, Marlow, N, for the EPICure Study Group. Specific language difficulties and school achievement in children born at 25 weeks gestation or less. J Pediatr. 2008; 152, 256262.
25. Dall'Oglio, A, Rossiello, B, Coletti, MF, et al. Do healthy preterm children need neuropsychological follow-up? Dev Med Child Neurol. 2010; 52, 955961.
26. Goyen, T-A, Lui, K. Developmental coordination disorder in ‘apparently normal’ school children born extremely preterm. Arch Dis Child. 2009; 94, 298302.
27. Cooke, RWI, Foulder-Hughes, L, Newsham, D, Clarke, D. Ophthalmic impairment at 7 years of age in children born very preterm. Arch Dise Child Fetal Neonatal Ed. 2004; 89, F249F253.
28. Darlow, BA, Clement, RS, Horwood, LJ, Mogridge, N. Prospective study of New Zealand infants with birth weight less than 1500 g and screened for retinopathy of prematurity: visual outcome at age 7–8 years. Br J Ophthalmol. 1997; 81, 935940.
29. Holmstrom, G, el Azazi, M, Kugelberg, U. Ophthalmological follow up of preterm infants: a population based, prospective study of visual acuity and strabismus. Br J Opthalmol. 1999; 83, 143150.
30. Foreman, N, Fielder, A, Minshell, C, Hurrion, E, Sergienko, E. Visual search, perception, and visual-motor skill in “healthy” children born at 27–32 weeks’ gestation. J Exp Child Psychol. 1997; 64, 2741.
31. Langaas, T, Mon-Williams, M, Wann, P, et al. Eye movements, prematurity and developmental co-ordination disorder. Vision Res. 1998; 38, 18171826.
32. Schraeder, BD, Heverly, MA, O'Brien, C, McEvoy-Shields, K. Finishing first grade: a study of school achievement in very-low-birth-weight children. Nurs Res. 1992; 41, 354361.
33. Dammann, O, Walther, H, Allers, B, et al. Development of a regional cohort of very-low-birthweight children at six years: cognitive abilities are associated with neurological disability and social background. Dev Med Child Neurol. 1996; 38, 97106.
34. Liebhardt, G, Sontheimer, D, Linderkamp, O. Visual-motor function of very low birth weight and full-term children at 3.5 to 4 years of age. Early Hum Dev. 2000; 57, 3347.
35. Dammann, O, Kuban, KCK, Leviton, A. Perinatal infection, fetal inflammatory response, white matter damage, and cognitive limitations in children born preterm. Ment Retard Dev Disabil Res Rev. 2002; 8, 4650.
36. Schmidt, B, Asztalos, EV, Roberts, RS, et al. Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms. JAMA. 2003; 289, 11241129.
37. Piecuch, RE, Leonard, CH, Cooper, BA, Sehring, SA. Outcome of extremely low birth weight infants (500 to 999 grams) over a 12-year period. Pediatrics. 1997; 100, 633639.
38. Stevenson, DK, Verter, J, Fanaroff, AA, et al. Sex differences in outcomes of very low birthweight infants: the newborn male disadvantage. Arch Dis Child Fetal Neonatal Ed. 2000; 83, F182F185.
39. Hoekstra, RE, Ferrara, TB, Couser, RJ, et al. Survival and long-term neurodevelopmental outcome of extremely premature infants born at 23–26 weeks’ gestational age at a tertiary center. Pediatrics. 2004; 113, e1e6.
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