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  • Social Determinants of Health and ROP Outcomes

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, May 2022

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    How are socioeconomic factors, in the context of race and ethnicity, related to outcomes of retinopathy of prematu­rity (ROP)? Karmouta et al. set out to answer this question in a study of 1,234 preterm neonates in the Los Angeles area. They found that gestational age (GA) was the primary driver of dispari­ties in ROP outcomes.

    For this retrospective cohort study, the researchers used U.S. Census Bu­reau income data and electronic med­ical records from four neonatal ICUs. Infants included in the study were born at a GA of 30 weeks or less or weighed less than 1,500 g at birth. Also included were those whose GA was greater than 30 weeks at birth but who also had an unstable clinical course and thus were deemed at high risk of ROP. The infants were screened for ROP between Jan. 1, 2010, and Dec. 31, 2020.

    The researchers collected data on race and ethnicity, GA, demograph­ics, clinical information, household income, and health insurance status. Main outcomes were diagnosis and severity of ROP.

    In an unadjusted analysis, His­panic neonates were more likely to be diagnosed with ROP and to have more severe disease. However, once the researchers adjusted for GA and socioeconomic factors, they found that lower GA was the primary predictor for ROP incidence (odds ratio [OR], .52; 95% CI, .48-.57; p < .001). In addition, higher median household income was associated with higher GA (OR, .26; 95% CI, .09-.43; p = .002).

    Overall, the study’s findings empha­size the role of socioeconomic factors in determining maternal health and fetal outcomes, the authors said, and future studies evaluating the impact that these additional risk factors have on ROP risk would be beneficial. (Also see related commentary by Alejandra G. de Alba Campomanes, MD, MPH, in the same issue.)

    The original article can be found here.