title: Is artificial reproductive technology a risk factor for retinopathy of prematurity independent of the generation of multiple births?
abstract: OBJECTIVE
  There is some debate regarding whether artificial reproductive technology (ART) constitutes an independent risk factor for retinopathy of prematurity (ROP). We wanted to assess the prevalence of ART in multiple birth infants seen for ROP screening and whether or not ROP was identified or treated, in order to evaluate whether ART contributes a risk factor for ROP independent of the generation of multiple births.
  
  
  METHODS
  A retrospective audit was performed of all multiple birth babies admitted to a tertiary neonatal unit who met the UK ROP screening criteria (<32 weeks gestational age [GA] and/or <1,501 g birthweight [BW]).
  
  
  RESULTS
  A total of 205 babies met our criteria, of whom 87.3% were twins. A total of 39.5% were born following ART. A total of 30.5% of the non-ART group developed ROP vs 34% of the ART group (p = 0.837). Stage 3 ROP developed in 5.1% of non-ART babies and 6% of ART babies. A total of 8.5% of non-ART babies and 10% of ART babies required treatment for ROP. Logistic regression demonstrated that ART was not independently associated with development of ROP.
  
  
  CONCLUSIONS
  Artificial reproductive technology multiple birth babies make up a considerable proportion of the ROP screening burden and their number is likely to increase as ART is increasingly available and utilized. We found no significant difference between the numbers of babies developing ROP in the ART vs non-ART groups, but the numbers are small. The estimated odds of developing ROP are slightly higher in the ART babies, so our data do not rule out a possible association.
authors.affiliation: Rwanda International Institute of Ophthalmology, Dr Agarwal's Eye Hospital, Kigali - Rwanda.
authors.forename: Lucy
authors.initials: L
authors.lastname: Barker
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London - UK.|NIHR Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology, London - UK.|London School of Hygiene and Tropical Medicine, London - UK.
authors.forename: Catey
authors.initials: C
authors.lastname: Bunce
authors.affiliation: Centre for Genomics and Child Health Blizard Institute, Barts and the London School of Medicine and Dentistry, London - UK.
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London - UK.
authors.forename: Gill G W
authors.initials: GG
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009099:Multiple Birth Offspring; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012099:Reproductive Techniques; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult