The Clinical Association of Maternal Asthma and the Development of Retinopathy of Prematurity in Preterm Infants

Purpose: Retinopathy of prematurity (ROP) is a major cause of childhood blindness worldwide. Infant risk factors such as low birth weight, early gestational age, and oxygen exposure are strongly associated with development of ROP. Establishing possible maternal factors, including maternal asthma, may assist in quantifying preterm infants’ risk of developing severe ROP. Methods: A retrospective observational study was performed using the records of the University of Colorado ROP registry from January 2006 to February 2024. Maternal asthma was identified upon review of patients’ clinic notes. Odds ratios (ORs) (with 95% CIs) for ROP risk factors were determined using multinomial logistic regression models, with ROP measures (stage, zone, type, and treatment) as the outcome and history of maternal asthma as the primary explanatory variable. A multivariable analysis was performed to control for birth weight and gestational age. Results: A total of 2237 infants met the inclusion criteria based on birth weight and gestational age, of whom 301 (13.5%) had a mother with a history of asthma. Of these infants, 23 (7.6%) developed type 1 ROP and 28 (9.3%) required treatment. Among infants with maternal asthma history, the adjusted ORs for developing type 1 ROP and type 2 ROP were 2.39 (95% CI, 1.30–4.41; P = .005) and 2.14 (95% CI, 1.25–3.67; P = .006), respectively, and these infants also had 1.87 higher odds (95% CI, 1.13–3.08) of requiring treatment compared with infants who had mothers without asthma (P = .0145). Conclusions: In this Colorado cohort, maternal asthma was associated with development of treatment-warranted ROP.