title: Increased Risk for Ophthalmic Complications in Patients with a History of Preterm Delivery.
abstract: Objective Spontaneous preterm deliveries (PTDs) have been consistently associated with maternal vascular complications. We aimed to investigate an association between PTD and subsequent maternal ophthalmic morbidity. Study Design In this population-based cohort study, we included all singleton deliveries occurring between 1988 and 2013. We excluded women with known ophthalmic disease. The exposure was at least one pregnancy with PTD. Outcomes included different maternal ophthalmic morbidity. The cumulative incidence and adjusted hazard ratios were assessed using a Kaplan-Meier survival curve and Cox hazards models. Results Of the 105,018 patients included, 17,600 (16.7%) delivered preterm. Patients with a history of PTD (both induced and spontaneous) had higher rates of ophthalmic complications (odds ratio [OR]: 2.12; confidence interval [CI]: 1.6-2.7; p < 0.001), specifically diabetic retinopathy and glaucoma (OR: 4.79 and 2.48, respectively). A linear association was found between the number of previous PTDs and ophthalmic complications (0.2% for no PTD; 0.4% for one PTD; 0.6% for two or more PTDs; p < 0.001) and for early and late PTD (p < 0.001). A Cox model revealed an independent association between PTD and ophthalmic complications (adjusted hazard ratio: 2.2; 95% CI: 1.6-2.9). Conclusion A history of PTD is an independent risk factor for ophthalmic morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Asnat
authors.initials: A
authors.lastname: Walfisch
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
authors.affiliation: Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Davidson
authors.affiliation: Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Beharier
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000209:etiology; D005128:Eye Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007557:Israel; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult