Effect of assisted reproductive technology on retinopathy of prematurity_Chinese Journal of Ocular Fundus Diseases

Authors：

Sun Zhihong ,  Sun Huiqing

Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital Zhengzhou Children's Hospital, Premature Infant Ward of Zhengzhou Children's Hospital, Zhengzhou 450028, China;

Corresponding?author：

Sun Huiqing, Email: s_huiqing@sina.com

Keywords：

Assisted reproductive technology; Retinopathy of prematurity; Gestational age; Birth weight

DOI：

10.3760/cma.j.cn511434-20220905-00489

Video：

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Objective To observe the effect of assisted reproductive technology (ART) on retinopathy of prematurity (ROP) in preterm infants. Methods A retrospective clinical study. From January 2016 to January 2020, 639 preterm infants who were hospitalized at Children's Hospital of Zhengzhou University and underwent fundus screening at a gestational age ≤32 weeks were included in the study. There were 366 males and 273 females. Gestational age at birth were (28.3±1.4) weeks; birth weight were (1 153.8±228.8) g. Severe ROP was detected in 60 cases (9.4%, 60/639); 120 were ART recipients, and 519 were naturally conceived, and were divided into the ART group and the control group accordingly. The incidence of gestational diabetes mellitus (χ²=21.675), pulmonary surfactant application (χ²=13.558), and twin births (yes) (χ²=145.568) in mothers of the children examined in both groups were significantly higher than that of the control group, and the difference were statistically significant in all cases (P＜0.001). Comparison of quantitative data between groups was performed by t-test, and comparison of count data was performed by χ² test; logistic regression was used to analyze the effect of ART on the incidence of ROP. Results Of the 60 cases of severe ROP, 18 (15.0%, 18/120) and 42 (8.1%, 42/519) cases were in the ART group and control group, respectively. The incidence of severe ROP was significantly higher in the ART group than in the control group, and the difference was statistically significant (χ²=4.680, P=0.024). Compared with the control group, the incidence of severe ROP was significantly higher in the ART group for gestational age at birth ＜28 weeks and birth weight ＜1 000 g, and the differences were statistically significant (χ²=10.116, 3.785; P=0.002, 0.037). Logistic regression analysis showed that ART was a non-independent risk factor for the occurrence of ROP (P＞0.05). Conclusion Assisted reproductive technology may have a certain influence on the occurrence of ROP, which is not an independent factor.

Citation： Sun Zhihong, Sun Huiqing. Effect of assisted reproductive technology on retinopathy of prematurity. Chinese Journal of Ocular Fundus Diseases, 2024, 40(1): 27-32. doi: 10.3760/cma.j.cn511434-20220905-00489 Copy

1.	海峽兩岸醫藥衛生交流協會眼科專業委員會小兒視網膜學組, 中華醫學會眼科學分會眼底病學組. 早產兒視網膜病變玻璃體腔注射抗血管內皮生長因子藥物治療的專家共識[J]. 中華眼底病雜志, 2021, 37(11): 836-840. DOI: 10.3760/cma.j.cn511434-20210916-00530.Pediatric Retinology Group, Ophthalmology Professional Committee of Cross-Strait Medical and Health Exchange Association, Fundus Disease Group of Ophthalmology Branch of Chinese Medical Association. Expert consensus on intravitreal injection of anti-vascular endothelial growth factor drugs for retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2021, 37(11): 836-840. DOI: 10.3760/cma.j.cn511434-20210916-00530.
2.	Cavoretto P, Candiani M, Giorgione V, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta-analysis of cohort studies[J]. Ultrasound Obstet Gynecol, 2018, 51(1): 43-53. DOI: 10.1002/uog.18930.
3.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement[J/OL]. PLoS Med, 2009, 6(7): e1000097[2009-07-21]. https://pubmed.ncbi.nlm.nih.gov/19621072/. DOI: 10.1371/journal.pmed.1000097.
4.	Blencowe H, Lawn JE, Vazquez T, et al. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010[J]. Pediatr Res, 2013, 74(Suppl 1): S35-49. DOI: 10.1038/pr.2013.205.
5.	李秋平, 張國明. 早產兒治療用氧和視網膜病變防治指南(修訂版)[J]. 發育醫學電子雜志, 2016, 4(4): 196-198. DOI: 10.3760/cma.j.issn.2095-428X.2013.23.023.Li QP, Zhang GM. Guidelines for the treatment of oxygen and the prevention and treatment of retinopathy in premature infants (revised edition)[J]. J Development Med, 2016, 4(4): 196-198. DOI: 10.3760/cma.j.issn.2095-428X.2013.23.023.
6.	中華醫學會眼科學分會眼底病學組. 中國早產兒視網膜病變篩查指南(2014年)[J]. 中華眼科雜志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Ophthalmology Group, Ophthalmology Society of Chinese Medical Association. Chinese screening guidelines for retinopathy of prematurity(2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
7.	Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants--2013 update[J]. Neonatology, 2013, 103(4): 353-368. DOI: 10.1159/000349928.
8.	Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop[J]. J Pediatr, 2018, 197: 300-308. DOI: 10.1016/j.jpeds.2018.01.043.
9.	侯新琳, 馮琪, 湯澤中, 等. 早產兒腦白質損傷診斷、防治與綜合管理的專家組意見[J]. 中國新生兒科雜志, 2015, 30(3): 175-177. DOI: 10.3969/j.issn.1673-6710.2015.03.006.Hou XL, Feng Q, Tang ZZ, et al. Expert group opinion on diagnosis, prevention and comprehensive management of white matter injury in premature infants[J]. Chinese Journal of Neonatology, 2015, 30(3): 175-177. DOI: 10.3969/j.issn.1673-6710.2015.03.006.
10.	Papile LA, Burstein J, Burstein R, et al. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm[J]. J Pediatr, 1978, 92(4): 529-534. DOI: 10.1016/s0022-3476(78)80282-0.
11.	童笑梅. 壞死性小腸結腸炎[M]//. 邵肖梅, 葉鴻瑁, 丘小汕. 實用新生兒學, 北京: 人民衛生出版社, 2011: 632-639.Tong XM. Necrotizing enterocolitis[M]//. Shao XM, Ye HM, Qiu XS. Practical neonatology. Beijing: People's Medical Publishing House, 2011: 632-639.
12.	Fierson WM. Screening examination of premature infants for retinopathy of prematurity[J/OL]. Pediatrics, 2018, 142(6): e20183061[2018-12-01]. https://pubmed.ncbi.nlm.nih.gov/30478242/. DOI: 10.1542/peds.2018-3061.
13.	Chen J, Smith LEH. Retinopathy of prematurity[J]. Angiogenesis, 2007, 10(2): 133-140. DOI: 10.1007/s10456-007-9066-0.
14.	Seggers J, Pontesilli M, Ravelli ACJ, et al. Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings[J]. Fertil Steril, 2016, 105(3): 590-598. DOI: 10.1016/j.fertnstert.2015.11.015.
15.	Mendoza R, Jáuregui T, Diaz-Nu?ez M, et al. Infertile couples prefer twins: analysis of their reasons and clinical characteristics related to this preference[J]. J Reprod Infertil, 2018, 19(3): 167-173.
16.	Kissin DM, Crawford S, Boulet SL. The status of public reporting of clinical outcomes in assisted reproductive technology[J/OL]. Fertil Steril, 2013, 100(3): e16-e17. https://pubmed.ncbi.nlm.nih.gov/23928256/. DOI: 10.1016/j.fertnstert.2013.07.199.
17.	Sullivan EA, Zegers-Hochschild F, Mansour R, et al. International committee for monitoring assisted reproductive technologies (ICMART) world report: assisted reproductive technology 2004[J]. Hum Reprod, 2013, 28(5): 1375-1390. DOI: 10.1093/humrep/det036.
18.	Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy[J]. Diabetes Care, 2012, 35(3): 556-564. DOI: 10.2337/dc11-1909.
19.	H?rtel C, Paul P, Hanke K, et al. Less invasive surfactant administration and complications of preterm birth[J/OL]. Sci Rep, 2018, 8(1): 8333[2018-05-29]. https://pubmed.ncbi.nlm.nih.gov/29844331/. DOI: 10.1038/s41598-018-26437-x.
20.	Termote J, Schalij-Delfos NE, Cats BP, et al. Less severe retinopathy of prematurity induced by surfactant replacement therapy[J]. Acta Paediatr, 1996, 85(12): 1491-1496. DOI: 10.1111/j.1651-2227.1996.tb13958.x.
21.	Kothe TB, Sadiq FH, Burleyson N, et al. Surfactant and budesonide for respiratory distress syndrome: an observational study[J]. Pediatr Res, 2020, 87(5): 940-945. DOI: 10.1038/s41390-019-0663-6.
22.	Rankin SJ, Tubman TR, Halliday HL, et al. Surfactant and ROP incidence[J]. Ophthalmology, 1991, 98(8): 1148-1149. DOI: 10.1016/s0161-6420(91)32160-2.
23.	Sunkara SK, Antonisamy B, Selliah HY, et al. Pre-term birth and low birth weight following preimplantation genetic diagnosis: analysis of 88 010 singleton live births following PGD and IVF cycles[J]. Hum Reprod, 2017, 32(2): 432-438. DOI: 10.1093/humrep/dew317.

1. 海峽兩岸醫藥衛生交流協會眼科專業委員會小兒視網膜學組, 中華醫學會眼科學分會眼底病學組. 早產兒視網膜病變玻璃體腔注射抗血管內皮生長因子藥物治療的專家共識[J]. 中華眼底病雜志, 2021, 37(11): 836-840. DOI: 10.3760/cma.j.cn511434-20210916-00530.Pediatric Retinology Group, Ophthalmology Professional Committee of Cross-Strait Medical and Health Exchange Association, Fundus Disease Group of Ophthalmology Branch of Chinese Medical Association. Expert consensus on intravitreal injection of anti-vascular endothelial growth factor drugs for retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2021, 37(11): 836-840. DOI: 10.3760/cma.j.cn511434-20210916-00530.
2. Cavoretto P, Candiani M, Giorgione V, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta-analysis of cohort studies[J]. Ultrasound Obstet Gynecol, 2018, 51(1): 43-53. DOI: 10.1002/uog.18930.
3. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement[J/OL]. PLoS Med, 2009, 6(7): e1000097[2009-07-21]. https://pubmed.ncbi.nlm.nih.gov/19621072/. DOI: 10.1371/journal.pmed.1000097.
4. Blencowe H, Lawn JE, Vazquez T, et al. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010[J]. Pediatr Res, 2013, 74(Suppl 1): S35-49. DOI: 10.1038/pr.2013.205.
5. 李秋平, 張國明. 早產兒治療用氧和視網膜病變防治指南(修訂版)[J]. 發育醫學電子雜志, 2016, 4(4): 196-198. DOI: 10.3760/cma.j.issn.2095-428X.2013.23.023.Li QP, Zhang GM. Guidelines for the treatment of oxygen and the prevention and treatment of retinopathy in premature infants (revised edition)[J]. J Development Med, 2016, 4(4): 196-198. DOI: 10.3760/cma.j.issn.2095-428X.2013.23.023.
6. 中華醫學會眼科學分會眼底病學組. 中國早產兒視網膜病變篩查指南(2014年)[J]. 中華眼科雜志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Ophthalmology Group, Ophthalmology Society of Chinese Medical Association. Chinese screening guidelines for retinopathy of prematurity(2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
7. Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants--2013 update[J]. Neonatology, 2013, 103(4): 353-368. DOI: 10.1159/000349928.
8. Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop[J]. J Pediatr, 2018, 197: 300-308. DOI: 10.1016/j.jpeds.2018.01.043.
9. 侯新琳, 馮琪, 湯澤中, 等. 早產兒腦白質損傷診斷、防治與綜合管理的專家組意見[J]. 中國新生兒科雜志, 2015, 30(3): 175-177. DOI: 10.3969/j.issn.1673-6710.2015.03.006.Hou XL, Feng Q, Tang ZZ, et al. Expert group opinion on diagnosis, prevention and comprehensive management of white matter injury in premature infants[J]. Chinese Journal of Neonatology, 2015, 30(3): 175-177. DOI: 10.3969/j.issn.1673-6710.2015.03.006.
10. Papile LA, Burstein J, Burstein R, et al. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm[J]. J Pediatr, 1978, 92(4): 529-534. DOI: 10.1016/s0022-3476(78)80282-0.
11. 童笑梅. 壞死性小腸結腸炎[M]//. 邵肖梅, 葉鴻瑁, 丘小汕. 實用新生兒學, 北京: 人民衛生出版社, 2011: 632-639.Tong XM. Necrotizing enterocolitis[M]//. Shao XM, Ye HM, Qiu XS. Practical neonatology. Beijing: People's Medical Publishing House, 2011: 632-639.
12. Fierson WM. Screening examination of premature infants for retinopathy of prematurity[J/OL]. Pediatrics, 2018, 142(6): e20183061[2018-12-01]. https://pubmed.ncbi.nlm.nih.gov/30478242/. DOI: 10.1542/peds.2018-3061.
13. Chen J, Smith LEH. Retinopathy of prematurity[J]. Angiogenesis, 2007, 10(2): 133-140. DOI: 10.1007/s10456-007-9066-0.
14. Seggers J, Pontesilli M, Ravelli ACJ, et al. Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings[J]. Fertil Steril, 2016, 105(3): 590-598. DOI: 10.1016/j.fertnstert.2015.11.015.
15. Mendoza R, Jáuregui T, Diaz-Nu?ez M, et al. Infertile couples prefer twins: analysis of their reasons and clinical characteristics related to this preference[J]. J Reprod Infertil, 2018, 19(3): 167-173.
16. Kissin DM, Crawford S, Boulet SL. The status of public reporting of clinical outcomes in assisted reproductive technology[J/OL]. Fertil Steril, 2013, 100(3): e16-e17. https://pubmed.ncbi.nlm.nih.gov/23928256/. DOI: 10.1016/j.fertnstert.2013.07.199.
17. Sullivan EA, Zegers-Hochschild F, Mansour R, et al. International committee for monitoring assisted reproductive technologies (ICMART) world report: assisted reproductive technology 2004[J]. Hum Reprod, 2013, 28(5): 1375-1390. DOI: 10.1093/humrep/det036.
18. Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy[J]. Diabetes Care, 2012, 35(3): 556-564. DOI: 10.2337/dc11-1909.
19. H?rtel C, Paul P, Hanke K, et al. Less invasive surfactant administration and complications of preterm birth[J/OL]. Sci Rep, 2018, 8(1): 8333[2018-05-29]. https://pubmed.ncbi.nlm.nih.gov/29844331/. DOI: 10.1038/s41598-018-26437-x.
20. Termote J, Schalij-Delfos NE, Cats BP, et al. Less severe retinopathy of prematurity induced by surfactant replacement therapy[J]. Acta Paediatr, 1996, 85(12): 1491-1496. DOI: 10.1111/j.1651-2227.1996.tb13958.x.
21. Kothe TB, Sadiq FH, Burleyson N, et al. Surfactant and budesonide for respiratory distress syndrome: an observational study[J]. Pediatr Res, 2020, 87(5): 940-945. DOI: 10.1038/s41390-019-0663-6.
22. Rankin SJ, Tubman TR, Halliday HL, et al. Surfactant and ROP incidence[J]. Ophthalmology, 1991, 98(8): 1148-1149. DOI: 10.1016/s0161-6420(91)32160-2.
23. Sunkara SK, Antonisamy B, Selliah HY, et al. Pre-term birth and low birth weight following preimplantation genetic diagnosis: analysis of 88 010 singleton live births following PGD and IVF cycles[J]. Hum Reprod, 2017, 32(2): 432-438. DOI: 10.1093/humrep/dew317.

Chinese Journal of Ocular Fundus Diseases

Effect of assisted reproductive technology on retinopathy of prematurity

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