16 Aug Does Maternal Preeclampsia Increase Risk of Retinopathy in Premature Infants?
MedicalResearch.com Interview with:
Dr. Hartnett
Mary Elizabeth Hartnett, MD, FACS, FARVO
Professor of Ophthalmology, Vitreoretinal Service and Surgery
Principal Investigator Retinal Angiogenesis Laboratory
Director of Pediatric Retina, Adjunct Professor of Pediatrics
John A. Moran Eye Center
Salt Lake City UT 84132
On behalf of the co-authors: Julia Shulman, Cindy Weng, Jacob Wilkes, Tom Greene, M. Elizabeth Hartnett
MedicalResearch.com: What is the background for this study?
Response: Maternal preeclampsia causes morbidity to mothers and infants worldwide. Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. This study was done to gain insight into the effects of preeclampsia on ROP in a clinical population.
The literature is mixed with some reports that preeclampsia increases risk of Retinopathy of prematurity, whereas others suggest preeclampsia is protective or has no effect. The presence of circulating anti-angiogenic factors in preeclamptic mothers that can enter the fetal circulation lends biologic plausibility to the notion that maternal preeclampsia might interfere with developing vascular beds in the fetus, such as the retina, and potentially lead to severe ROP. However, a report using an experimental model provided evidence that uteroplacental insufficiency, a characteristic of preeclampsia, led to protective mechanisms in the offspring that reduced oxygen-induced retinopathy and promoted overall growth.
MedicalResearch.com: What are the main findings?
Response: A large cohort in Utah of all live births for the last decade was retrospectively analyzed. The full cohort included mothers with or without preeclampsia and their offspring born either full term or premature. Generalized estimating equations for logistic regressions with covariate adjustment were performed first for the entire cohort and then again for a subcohort restricted to only premature infants of very-low birth weight (<1500 g and < 31 weeks gestational age). Analyses of the full cohort found that preeclampsia increased the risk of ROP and of severe, treatment warranted, ROP. However, when the analyses were restricted only to premature very-low birth weight infants, preeclampsia was associated with a reduced risk of Retinopathy of prematurity,.
MedicalResearch.com: What should readers take away from your report?
Response: Although these conflicting associations in the full cohort and restricted subcohort may reflect true differences, the association of a reduced risk in the subcohort may also reflect biases from restricting the cohort to prematurity because prematurity is an outcome of preeclampsia.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: In observational studies, which clinical studies on ROP and preeclampsia often are, it is important to clarify the characteristics of patients being studied. To understand potential biologic effects relating preeclampsia and ROP, studies that use experimental models, which translate to human maternal/fetal stresses, are needed.
Disclosures: NIH NEI R01EY015130, R01EY017011 (MEH- PI) and NIH NCATS UL1TR001067; Departmental grant from Research to Prevent Blindness to the Department of Ophthalmology
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Last Updated on August 16, 2017 by Marie Benz MD FAAD