Objective: The aim of this population-based study was to evaluate the temporal trends in the incidence of retinopathy of prematurity (ROP) and the demographic and clinical factors associated with ROP.
Methods: In this population-based observational cohort study data from the Israel national very low birthweight infant database were used. Following exclusions, the final study population comprised 16,257 infants born at 23-29 weeks. The independent effect of variables associated with ROP was assessed using multivariable logistic regression. P values for trend were determined by applying the Cochran-Armitage Trend Test.
Results: The rates of ROP decreased from 32.9% in the years 1995-2000 to 16.0% in 2017-2021 (p < 0.0001). In comparison to the reference epoch (1995-2000), the adjusted odds ratio (OR) [95% confidence interval] for ROP, were significantly lower in 2001-2006 (OR 0.68 [0.59-0.77]), in 2007-2011 (OR 0.36 [0.31-0.42]), in 2012-2016 (OR 0.31 [0.26-0.36]), and in 2017-2021 (OR 0.32 [0.27-0.39]). Sepsis (OR 1.67 [1.52-1.83]), surgically treated necrotizing enterocolitis (NEC) (OR 1.86 [1.49-2.32]) and surgically treated patent ductus arteriosus (PDA) (OR 1.88 [1.56-2.27]) were associated with ROP. Among the infants with sepsis, surgically treated PDA or surgically treated NEC, the rates of ROP increased in the 2017-2021 epoch.
Conclusions: The odds for ROP decreased by over two-thirds throughout the period 1995-2021, although the decline was attenuated in the recent decade. In view of the independent association found between surgically treated PDA or NEC and ROP, and the increasing rates of ROP in these infants, further studies may elucidate whether earlier ROP screening and possibly earlier therapeutic interventions may be appropriate for these infants.
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