Key PointsQuestion听
How has screening for and incidence of retinopathy of prematurity (ROP) changed in California from January 2012 to December 2021?
Findings听
In this cohort study, screening rates for ROP in California remained at 95% or higher for eligible infants from January 2012 to December 2021. Among 36鈥�113 very preterm infants who had undergone retinal examination, the incidence of ROP stayed the same or decreased across race and ethnicity and the incidence of severe ROP stayed the same across race and ethnicity from 2012 to 2021 in California.
Meaning听
In contrast to rising national incidence rates of ROP, the incidence of ROP and racial and ethnic disparities in ROP stayed the same or improved from 2012 to 2021 in California.
Importance听
The incidence of retinopathy of prematurity (ROP) has been increasing in the US since 2003. Understanding the progression of and racial disparities in ROP incidence in California can provide a contrasting perspective that may guide future research and practice in the management and prevention of ROP.
Objective听
To describe how the screening and incidence of ROP among very preterm infants in California changed from January 1, 2012, to December 31, 2021.
Design, Setting, and Participants听
This study used a cohort of very preterm infants (defined as infants born prior to 32 weeks鈥� gestational age or weighing less than 1500 g) admitted to 60 neonatal intensive care units across California from January 1, 2012, to December 31, 2021. Among this cohort, several factors were examined, including (1) the clinical and sociodemographic covariates of the population with and without ROP, (2) trends in screening for ROP, and (3) the incidence of ROP in total and by race and ethnicity. Data analysis was performed in April 2024.
Exposures听
Race and ethnicity and other birthing parental and infant descriptive characteristics.
Main Outcomes and Measures听
Incidence rates of ROP and severe ROP. The primary measures were rates of ROP screening and incidence rates of ROP and severe ROP. Time trends in the risk of ROP and severe ROP were estimated using robust Poisson regression models.
Results听
In this cohort of 39鈥�269 very preterm infants (<32 weeks鈥� gestational age) eligible for ROP screening, the mean (SD) infant gestational age was 28.6 (2.6) weeks. The mean (SD) birth weight was 1075 (274) g, and 48.6% of infants were female. The birthing parents of the population were 12.6% Asian, 13.3% Black, 44.9% Hispanic White or Hispanic other race, 0.7% Native American/Alaskan, 24.7% non-Hispanic White, and 1.0% Pacific Islander. From January 1, 2012, to December 31, 2021, in California, ROP screening rates remained steady at 95% or greater for eligible infants less than 30 weeks of gestational age for all race and ethnic subgroups. In this study cohort among all very preterm infants (<32 weeks鈥� gestational age), the incidence of ROP decreased from 31% in 2012 to 29% in 2021. Incidence rates of ROP among Asian and Hispanic individuals decreased the most quickly compared to other racial and ethnic groups, narrowing disparities.
Conclusions and Relevance听
In this cohort study, in contrast to increasing national trends, the total incidence of and racial and ethnic disparities in ROP incidence remained steady or decreased from 2012 to 2021 in California.