Association between Artificial Reproductive Technology and Retinopathy of Prematurity

Kiril Slaveykov; Kalina Trifonova; Hristo Mumszhiev

doi:10.3889/oamjms.2021.4907

Authors

Kiril Slaveykov Department of Internal Disease and General Medicine, Trakia University, Stara Zagora, Bulgaria
Kalina Trifonova Department of Internal Disease and General Medicine, Trakia University, Stara Zagora, Bulgaria
Hristo Mumszhiev Department of Internal Disease and General Medicine, Trakia University, Stara Zagora, Bulgaria

DOI:

https://doi.org/10.3889/oamjms.2021.4907

Keywords:

Artificial Reproductive Technology, Retinopathy of Prematurity, Infants, Laser Treatment

Abstract

BACKGROUND: Infertility is an increasingly common health problem which affects approximately 10% of the women in reproductive age. Artificial reproductive technology (ART), which is the modern solution to infertility, unfortunately has been linked to increased prevalence of prematurity and low birth weight (BW) in the newborn. Thatâ€™s why ART infants make up a considerable portion of the retinopathy of prematurity (ROP) screening burden, which is likely to increase, as ART becomes increasingly available and utilized.

AIM: The aim of the study was to assess the association between ART and the development of ROP.

MATERIALS AND METHODS: Retrospective analysis of preterm infants screened for ROP at the Neonatal Intensive Care Unit in the University Hospital â€oeProf. Dr. Stoyan Kirkovichâ€ Stara Zagora, Bulgaria, by single factor and multifactor logistic regression models.

RESULTS: During a 4-year period (2016–2019), 419 infants, meeting the screening criteria, were admitted in the ward. Out of them, 265 were conceived naturally and 154 through ART. Thirty-two (7.6%) children required laser treatment for ROP, among which 15 (46.87%) were conceived naturally and 17 (53.12%) by ART. Multifactor analyses proves BW (odds ratio [OR] 0.99; confidence interval [CI], 0.98â€“0.99; p = 0.008) and gestational age (GA) (OR 0.296; 95% CI 0.09â€“0.88; p = 0.029) as significant risk factors for severe ROP, requiring treatment.

CONCLUSION: ART is a risk factor for ROP due to its association with lower BW and GA of the newborn infants, rather than directly increasing the possibility for it. Nevertheless, there is a pronounced trend for more severe ROP to develop in ART children, when compared to naturally conceive in the same weight group.

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References

Szamatowicz M. Assisted reproductive technology in reproductive medicine-possibilities and limitations. Ginekol Pol. 2016;87(12):820-3. https://doi.org/10.5603/gp.2016.0095 PMid:28098933

Barker L, Bunce C, Husain S, Adams GG. Is artificial reproductive technology a risk factor for retinopathy of prematurity independent of the generation of multiple births? Eur J Ophthalmol. 2017;27(2):174-8. https://doi.org/10.5301/ejo.5000832

Valentine PH, Jackson JC, Kalina RE, Woodrum DE. Increased survival of low birth weight infants: Impact on the incidence of retinopathy of prematurity. Pediatrics. 1989;84(3):442-5. PMid:2788864

Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84(2):77-82. https://doi.org/10.1016/j.earlhumdev.2007.11.009 PMid:18234457

De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: Results generated from European registries by ESHRE: The European IVF-monitoring consortium (EIM) for the European society of human reproduction and embryology (ESHRE). Hum Reprod. 2018;33(9):1586-601. https://doi.org/10.1093/hropen/hoaa038 PMid:30032255

Chan RP, Yonekawa Y, Morrison MA, Sun G, Wong RK, Perlman JM, et al. Association between assisted reproductive technology and advanced retinopathy of prematurity. Clin Ophthalmol. 2010;4:1385-90. https://doi.org/10.2147/opth.s15587 PMid:21179223

Watts P, Adams GG. In vitro fertilisation and stage 3 retinopathy of prematurity. Eye (Lond). 2000;14(3):330-3. https://doi.org/10.1038/eye.2000.82 PMid:11026994

Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity-risk factors. Indian J Pediatr. 2004;71(10):887-92. https://doi.org/10.1007/bf02830827 PMid:15531829

Darlow BA, Horwood LJ, Clemett RS. Retinopathy of prematurity: Risk factors in a prospective population-based study. Paediatr Perinat Epidemiol. 1992;6(1):62-80. https://doi.org/10.1111/j.1365-3016.1992.tb00747.x PMid:1553319

Brown DR, Milley JR, Ripepi UJ, Biglan AW. Retinopathy of prematurity: Risk factors in a five-year cohort of critically ill premature neonates. Am J Dis Child. 1987;141(2):154-60. https://doi.org/10.1001/archpedi.1987.04460020044024 PMid:3101483

Holmström G, Broberger U, Thomassen P. Neonatal risk factors for retinopathy of prematurity-a population-based study. Acta Ophthalmol Scand. 1998;76(2):204-7. https://doi.org/10.1034/j.1600-0420.1998.760216.x PMid:9591954

Garg R, Agthe AG, Donohue PK, Lehmann CU. Hyperglycemia and retinopathy of prematurity in very low birth weight infants. J Perinatol. 2003;23(3):186-94. https://doi.org/10.1038/sj.jp.7210879 PMid:12732854

Alajbegovic-Halimic J, Zvizdic D, Alimanovic-Halilovic E, Dodik I, Duvnjak S. Risk factors for retinopathy of prematurity in premature born children. Med Arch. 2015;69(6):409-13. https://doi.org/10.5455/medarh.2015.69.409-413 PMid:26843736

DeAngelis MM, Ji F, Kim IK, Adams S, Capone A, Ott J, et al. Cigarette smoking, CFH, APOE, ELOVL4, and risk of neovascular age-related macular degeneration. Arch Ophthalmol. 2007;125(1):49-54. https://doi.org/10.1001/archopht.125.1.49 PMid:17210851

DeAngelis MM, Lane AM, Shah CP, Ott J, Dryja TP, Miller JW. Extremely discordant sib-pair study design to determine risk factorsfor neovascular age-related macular degeneration. Arch Ophthalmol. 2004;122(4):575-80. https://doi.org/10.1001/archopht.122.4.575 PMid:15078676

Grozeva E, Simova J, Vankova D, Naneva Z, Grupcheva C. Retinopathy of prematurity-a bulgarian perspective of a global epidemic. Scr Sci Salutis Public. 2016;2(1):37-45. https://doi.org/10.14748/sssp.v1i1.1499

Marinov V. Retinopathy of the Prematurity-Incidence, Predictive Factors, Stages and Behavior. Dissertation Work, Bulgaria, Plovdiv; 2013.

Mladenov O, Chernodrinska V, Petkova I, Dimitrova G, Kemilev P, Oscar AH, et al. Retinopathy of prematurity-incidence and risk factors in Bulgaria. Int J Pharm Sci Invent. 2017;6(7):18-23. https://doi.org/10.7546/crabs.2020.02.18

Yau GS, Lee JW, Tam VT, Yip S, Cheng E, Liu CC, et al. Incidence and risk factors for retinopathy of prematurity in multiple gestations: A Chinese population study. Medicine (Baltimore). 2015;94(18):e867. https://doi.org/10.1097/md.0000000000000867 PMid:25950699

McKibbin M, Booth AP, Dabbs TR. In vitro fertilisation and stage 3 retinopathy of prematurity. Eye (Lond). 2001;15(3):363-4. PMid:11450754

McKibbin M, Dabbs TR. Assisted conception and retinopathy of prematurity. Eye (Lond). 1996;10(4):476-8. https://doi.org/10.1038/eye.1996.105 PMid:8944102

Gao L, Shao W, Li N, Tian C, Jia H, Peng X, et al. The risk of retinopathy of prematurity in the Infants following assisted reproductive technology: A meta-analysis. Biomed Res Int. 2019;2019:2095730. https://doi.org/10.1155/2019/2095730 PMid:31380413

Trifonova K, Slaveykov K, Mumdzhiev H, Dzhelebov D. Artificial reproductive technology-a risk factor for retinopathy of prematurity. Open Access Maced J Med Sci. 2018;6(11):2245-9. PMid:30559896

Yonekawa Y, Sun G, Weissman M, Perlman JM, Shin H, Chiang MF, et al. The association between assisted conception and progression of retinopathy of prematurity. Invest Ophthalmol Vis Sci. 2008;49(13):1400.

Wong RK, Yonekawa Y, Sun G, DeAngelis MM, Morrison M, Chiang MF, et al. Update: Assisted conception and progression of retinopathy of prematurity. Invest Ophthalmol Vis Sci. 2009;50(13):3143.

Ho CH, Peng FS, Chen HF, Lien YR, Chen SU, Yang YS. Twin pregnancies conceived by assisted reproductive technology: Maternal and perinatal outcomes. Taiwan J Obstet Gynecol. 2005;44(4):332-7. https://doi.org/10.1016/s1028-4559(09)60166-2

Friling R, Axer-Siegel R, Hersocovici Z, Weinberger D, Sirota L, Snir M. Retinopathy of prematurity in assisted versus natural conception and singleton versus multiple births. Ophthalmology. 2007;114(2):321-4. https://doi.org/10.1016/j.ophtha.2006.11.010 PMid:17270680

Chiarelli L, Mirea L, Yang J, Lee SK, Shah PS, on Behalf of the Canadian Neonatal Network. Neonatal outcomes in very preterm singleton infants conceived using assisted reproductive technologies. Am J Perinatol. 2015;32(6):515-22. https://doi.org/10.1055/s-0034-1396699 PMid:25539408

Funnell CL, Dabbs TR. Assisted conception and retinopathy of prematurity: 8-year follow-up study. Eye (Lond). 2007;21(3):383-6. https://doi.org/10.1038/sj.eye.6702215 PMid:16410811

Yang MB, Donovan EF, Wagge JR. Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity. J AAPOS. 2006;10(3):253-61. https://doi.org/10.1016/j.jaapos.2006.01.004 PMid:16814180