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Retinopathy of prematurity and antenatal corticosteroids. The Italian ROP Study Group.

OBJECTIVES
It is not known whether antenatal corticosteroids (ANS) can reduce the risk of retinopathy of prematurity (ROP). The aim of this study was to evaluate in a prospective cohort study the effect of ANS on ROP development and severity.


METHODS
All infants consecutively admitted to 14 centres from 1.1.1992 to 31.12.1993, with a gestational age < or = 30 weeks, no congenital anomalies, and who survived to 6 months, were enrolled (N = 380). Mean birth weight of the cohort was 1157 g; mean gestational age was 28.4 weeks. ROP stage 1-2 developed in 82 neonates; ROP stage 3-3+ in 57. Only 70 neonates (18.4%) received ANS prophylaxis.


RESULTS
ANS prophylaxis highly significantly reduced the risk of developing ROP [Odds ratio, (OR), 0.35; 95% confidence interval 0.17-0.71, logistic regression analysis], and that of severe (stage 3-3+) ROP (OR 0.07; 95% confidence interval: 0.02-0.34). Short gestation, low birth weight, bronchopulmonary dysplasia also were significantly associated with ROP development and severity; respiratory distress syndrome and not being treated with surfactant were significant risk factors for ROP severity.


CONCLUSIONS
ANS prophylaxis protected both against ROP development and against severe forms of ROP. Prematurity and respiratory morbidity still represent independent risk factors for ROP.