Antenatal dexamethasone and decreased severity of retinopathy of prematurity.

OBJECTIVE To assess risk factors associated with the development of retinopathy of prematurity (ROP) in an urban population. DESIGN Observational cohort study. SETTING Bellevue Hospital Center, a regional perinatal referral center in New York City. PATIENTS Surviving inborn infants with birth weight less than 1250 g undergoing an ophthalmologic screening examination. MAIN OUTCOME MEASURES Screening examination results for ROP were obtained. Additional data included birth weight, gestational age, maternal factors, and common neonatal diagnoses and exposures. RESULTS Sixty-three infants were included in the analysis. Mean +/- SD birth weight was 981+/-179 g and mean gestational age was 27.8+/-2.4 weeks. Infants whose mothers received antenatal dexamethasone developed significantly less ROP that was stage 2 or higher than infants without a history of antenatal dexamethasone exposure--8.7% (2/23) vs 35% (14/40), respectively (P=.04). Birth weight, gestational age, respiratory distress syndrome, bronchopulmonary dysplasia, and patent ductus arteriosus were also significantly associated with the development of ROP that was stage 2 or higher. After controlling for these confounders by multiple logistic regression analysis, antenatal dexamethasone administration was associated with a significantly decreased risk of development of ROP stage 2 or higher (adjusted odds ratio [OR], 0.14; 95% confidence interval [CI], 0.02-0.93). The association was stronger when the analysis was restricted to the 36 infants who were 24 to 28 weeks of gestational age (adjusted OR, 0.02; 95% CI, 0.00-0.76). CONCLUSION Antenatal dexamethasone administration appears to be associated with a decreased incidence of development of ROP of stage 2 or higher in this urban population.