• Maternal Preeclampsia, Risk of Premature Birth, and ROP

    Written By: Lynda Seminara
    Selected By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, September 2017

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    Studies of the effect of preeclampsia on premature birth and retinopathy of prematurity (ROP) have produced conflicting results. In research aimed at clarifying this relationship and explain­ing the discrepancies, Shulman et al. found that preeclampsia was associated with elevated risk of ROP in an unre­stricted cohort, but it reduced the risk of ROP in a preterm-only cohort.

    For this study, the researchers reviewed records of 290,992 live births that occurred during a 10-year period (January 2001–December 2010). They used generalized estimating equations for logistic regression, with covariate adjustment, to determine the relationship between ROP and maternal pre­eclampsia among 2 cohorts: the entire study population and the preterm sub­group with very low birth weight born before 31 weeks’ gestation (n = 2,015). Infants in the latter group weighed < 1,500 g.

    In the full (unrestricted) cohort, preeclampsia was associated with an in­creased risk of all ROP, severe ROP, in­fant death, and having a premature/low birth weight baby. In the premature/low birth weight cohort, preeclampsia was inversely associated with all ROP, severe ROP, and infant death.

    In conclusion, these findings suggest an overall adverse effect of preeclamp­sia on ROP and are consistent with evidence of a protective effect of pre­eclampsia on infants born prematurely. However, it is unclear whether the latter denotes a true direct protective effect, collider bias, and/or another form of uncontrolled confounding.

    The original article can be found here.