Neurodevelopmental outcomes in very low birthweight infants with retinopathy of prematurity in a nationwide cohort study

Abstract

In a nationwide prospective cohort of Korean infants with very low birthweights (VLBW, birth weight < 1500 g) from 70 neonatal intensive care units of the Korean Neonatal Network, we investigated neurodevelopmental outcomes in preterm infants with retinopathy of prematurity (ROP) from 2132 infants with VLBW who had undergone developmental assessments at 18-24 months of corrected age. Motor, cognitive, or language delay was determined using developmental scores that were less than 1 standard deviation from the average. Comparative analyses and multivariate regression analyses were performed to validate the association between ROP or its treatment and developmental delay. Motor (52.8% vs. 36.3%), cognitive (46.8% vs. 31.6%), and language delays (42.5% vs. 28.4%) were noted more frequently in infants with ROP than in those without ROP; this was statistically significant (all P < 0.001). Multivariate analyses showed that motor and cognitive delays were significantly associated with ROP. There were no remarkable differences between the neurodevelopmental outcomes and the treatment modalities (laser photocoagulation, anti-vascular endothelial growth factor injection, or both) for ROP, and both stratification and multivariate regression analyses confirmed no significant association between anti-vascular endothelial growth factor therapy and neurodevelopmental delay. As ROP is significantly associated with poor neurodevelopmental outcomes independent of extreme prematurity, neurodevelopmental functions should be given attention in infants with ROP.

Figure 1

Flowchart illustrating the inclusion and exclusion criteria of the present study and the number of infants meeting the criteria. VLBW Very Low birthweight; ROP retinopathy of prematurity.