A meta-analysis of adverse effects of retinopathy of prematurity on neurodevelopment in preterm infants

Abstract

Background: Retinopathy of prematurity (ROP) increases with the survival of late preterm infants, but its relationship with neurodevelopmental outcomes in preterm infants remains controversial. To investigate the relationship between ROP and its severity and adverse neurodevelopmental outcomes in preterm infants. Methods: We conducted a meta-analysis. All relevant literature before November 2022 were retrieved from PubMed, Embase, Cochrane Library Web of Science, CNKI, CBM, Wan fang Data, and VIP Database. According to the inclusion criteria and exclusion criteria, eligible literature were included to conduct clinical trial quality assessment, and the Newcastle-Ottawa scale was used to evaluate the quality of evidence. Meta-analysis was performed using RevMan5.3. Data extraction, quality assessment, and meta-analysis were performed independently by 2 people. Mean difference or standardized mean difference of motor, language and cognitive scores (Bayley III or Bayley II) were used as effect sizes for continuous data analysis, all of which were represented by 95% CI. For heterogeneity (I 2 ≥ 50% or P < .10), a random effects model was used, otherwise a fixed effects model was used. Results: A total of 6 literature were included. The results of the ROP group for motor (comprehensive motor, proportional motor, and fine motor), language and cognitive scores were −5.57 (95%CI, −1.43 to 0.04), −0.95 (95%CI, 1.4–0.50), −1.34 (95% CI, 1.77–0.92), −1.75 (95% CI, 2.26–1.24) and −5.56 (95% CI, 9.56–1.57). Additionally, the results of severe ROP group for motor (comprehensive motor, proportional motor, fine motor), language and cognitive scores were −8.32 (95%CI, −8.91 to 7.74), −1.10 (95%CI, −1.83 to −0.36), −1.08 (95%CI, −1.75 to −0.41), −7.03 (95%CI, −7.71 to 6.35), and −7.96 (95%CI, −8.5 to −7.42). Conclusions: The Bayley Scale scores of the ROP group were lower than those of the not ROP group, and the scores of the severe ROP were significantly lower than those of the not severe ROP group. These findings suggest that ROP can indeed delay motor, language and cognitive, especially in severe cases.