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.