{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:47:03Z","timestamp":1793947623846,"version":"4.8.0"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Ophthalmol"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:sec id=\"ab-eoi230013-4\"><jats:title>Importance<\/jats:title><jats:p>Retinopathy of prematurity (ROP) is a potentially blinding retinal disease with poorly defined epidemiology. Understanding of which infants are most at risk for developing ROP may foster targeted detection and prevention efforts.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-5\"><jats:title>Objective<\/jats:title><jats:p>To identify changes in ROP incidence in the US from 2003 to 2019.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective database cohort study used the Healthcare Cost and Utilization Project Kids\u2019 Inpatient Databases. These nationwide databases are produced every 3 years, include data from over 4000 hospitals, and are designed to generate national estimates of health care trends in the US. Participants included pediatric newborns at risk for ROP development between 2003 and 2019. Data were analyzed from September 30, 2021, to January 13, 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-7\"><jats:title>Exposures<\/jats:title><jats:p>Premature or low-birth-weight infants with relevant <jats:italic>International Classification of Diseases, Ninth Revision<\/jats:italic> or <jats:italic>Tenth Revision <\/jats:italic>codes were considered ROP candidates. Infants with ROP were identified using relevant codes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>ROP incidence in selected subpopulations (based on database-reported race and ethnicity, sex, location, income) was measured. To determine whether incidences varied across time or subpopulations, \u03c7<jats:sup>2<\/jats:sup> tests of independence were used.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-9\"><jats:title>Results<\/jats:title><jats:p>This study included 125\u202f212 ROP discharges (64\u202f715 male infants [51.7%]) from 23\u202f187\u202f683 births. The proportion of premature infants diagnosed with ROP increased from 4.4% (11\u202f720 of 265\u202f650) in 2003 to 8.1% (27\u202f160 of 336\u202f117) in 2019. Premature infants from the lowest median household income quartile had the greatest proportional increase of ROP diagnoses from 4.9% (3244 of 66\u202f871) to 9.0% (9386 of 104\u202f235; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Premature Black infants experienced the largest increase from 5.8% (2124 of 36\u202f476) to 11.6% (7430 of 63\u202f925; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) relative to other groups (2.71%; 95% CI, 2.56%-2.87%; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Hispanic infants experienced the second largest increase from 4.6% (1796 of 39\u202f106) to 8.2% (4675 of 57\u202f298; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) relative to other groups (\u22120.16%; 95% CI, \u22120.29% to \u22120.03%; <jats:italic>P<\/jats:italic>\u2009=\u2009.02). The Southern US experienced the greatest proportional growth of ROP diagnoses, increasing from 3.7% (3930 of 106\u202f772) to 8.3% (11\u202f952 of 144\u202f013; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) relative to other groups (1.61%; 95% CI, 1.51%-1.71%; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). ROP diagnoses proportionally increased in urban areas and decreased in rural areas.<\/jats:p><\/jats:sec><jats:sec id=\"ab-eoi230013-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This cohort study found that ROP incidence among premature infants increased from 2003 to 2019, especially among Black and Hispanic infants. Infants from the lowest-income areas persistently had the highest proportional incidence of ROP, and all regions experienced a significant increase in ROP incidence with the most drastic changes occurring in the South. These trends suggest that ROP is a growing problem in the US and may be disproportionately affecting historically marginalized groups.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaophthalmol.2023.0809","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T15:11:42Z","timestamp":1681398702000},"page":"479","source":"Crossref","is-referenced-by-count":99,"title":["Epidemiology of Retinopathy of Prematurity in the US From 2003 to 2019"],"prefix":"10.1001","volume":"141","author":[{"given":"Anshul","family":"Bhatnagar","sequence":"first","affiliation":[{"name":"School of Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry C.","family":"Skrehot","sequence":"additional","affiliation":[{"name":"School of Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Texas Children\u2019s Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honey","family":"Herce","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Texas Children\u2019s Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Y.","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"26","key":"eoi230013r1","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1056\/NEJMra1208129","article-title":"Mechanisms and management of retinopathy of prematurity.","volume":"367","author":"Hartnett","year":"2012","journal-title":"N Engl J Med"},{"issue":"2","key":"eoi230013r2","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.earlhumdev.2007.11.007","article-title":"Treatment of retinopathy of prematurity.","volume":"84","author":"Clark","year":"2008","journal-title":"Early Hum Dev"},{"issue":"2","key":"eoi230013r3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.earlhumdev.2007.11.009","article-title":"Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control.","volume":"84","author":"Gilbert","year":"2008","journal-title":"Early Hum Dev"},{"issue":"6","key":"eoi230013r4","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1053\/j.semperi.2019.05.002","article-title":"Epidemiology of ROP update\u2014Africa is the new frontier.","volume":"43","author":"Gilbert","year":"2019","journal-title":"Semin Perinatol"},{"issue":"7","key":"eoi230013r5","doi-asserted-by":"publisher","first-page":"553","DOI":"10.3928\/23258160-20170630-06","article-title":"The epidemiology of retinopathy of prematurity in the US.","volume":"48","author":"Ludwig","year":"2017","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"issue":"8","key":"eoi230013r6","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1001\/archophthalmol.2011.192","article-title":"Retinopathy of prematurity: do we still have a problem?\u2014the Charles L. Schepens lecture.","volume":"129","author":"Tasman","year":"2011","journal-title":"Arch Ophthalmol"},{"issue":"8","key":"eoi230013r7","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1001\/jamaophthalmol.2021.1853","article-title":"When the N is 65 million\u2014the rise of database research.","volume":"139","author":"Weng","year":"2021","journal-title":"JAMA Ophthalmol"},{"issue":"5","key":"eoi230013r9","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1001\/jamapediatrics.2019.0180","article-title":"Outcomes of extremely preterm infants with birth weight less than 400 g.","volume":"173","author":"Brumbaugh","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"7","key":"eoi230013r10","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1056\/NEJMoa1605566","article-title":"Survival and neurodevelopmental outcomes among periviable infants.","volume":"376","author":"Younge","year":"2017","journal-title":"N Engl J Med"},{"key":"eoi230013r11","doi-asserted-by":"publisher","first-page":"3467","DOI":"10.2147\/OPTH.S324614","article-title":"Incidence and risk factors for retinopathy of prematurity (ROP) in biggest neonatal intensive care unit in Itay El-Baroud city, Behera Province, Egypt.","volume":"15","author":"Gaber","year":"2021","journal-title":"Clin Ophthalmol"},{"issue":"10","key":"eoi230013r12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0109460","article-title":"Low birth weight is a risk factor for severe retinopathy of prematurity depending on gestational age.","volume":"9","author":"Lundgren","year":"2014","journal-title":"PLoS One"},{"issue":"3","key":"eoi230013r13","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1001\/archpedi.155.3.387","article-title":"Evidence for changing guidelines for routine screening for retinopathy of prematurity.","volume":"155","author":"Lee","year":"2001","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"10077","key":"eoi230013r14","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(17)30569-X","article-title":"Structural racism and health inequities in the USA: evidence and interventions.","volume":"389","author":"Bailey","year":"2017","journal-title":"Lancet"},{"issue":"1","key":"eoi230013r15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/S0161-6420(91)32350-9","article-title":"Incidence and characteristics of retinopathy of prematurity in a low-income inner-city population.","volume":"98","author":"Charles","year":"1991","journal-title":"Ophthalmology"},{"issue":"6","key":"eoi230013r16","doi-asserted-by":"publisher","first-page":"717","DOI":"10.4103\/ijo.IJO_496_19","article-title":"The changing scenario of retinopathy of prematurity in middle- and low-income countries: unique solutions for unique problems.","volume":"67","author":"Vinekar","year":"2019","journal-title":"Indian J Ophthalmol"},{"issue":"2","key":"eoi230013r17","first-page":"90","article-title":"Continuing challenges in rural health in the USS.","volume":"5","author":"Coughlin","year":"2019","journal-title":"J Environ Health Sci"},{"issue":"11","key":"eoi230013r18","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1097\/IAE.0000000000003218","article-title":"Geographic access disparities to clinical trials in retinopathy of prematurity in the US.","volume":"41","author":"Soares","year":"2021","journal-title":"Retina"},{"issue":"4","key":"eoi230013r19","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1089\/tmj.2020.0010","article-title":"Telemedicine for retinopathy of prematurity.","volume":"26","author":"Brady","year":"2020","journal-title":"Telemed J E Health"},{"issue":"9393","key":"eoi230013r21","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1016\/S0140-6736(03)14631-4","article-title":"Severe visual impairment and blindness in children in the UK.","volume":"362","author":"Rahi","year":"2003","journal-title":"Lancet"},{"issue":"7","key":"eoi230013r22","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1038\/s41372-020-0635-z","article-title":"Estimates of healthcare spending for preterm and low-birth-weight infants in a commercially insured population: 2008-2016.","volume":"40","author":"Beam","year":"2020","journal-title":"J Perinatol"},{"key":"eoi230013r8","unstructured":"Agency for Healthcare Research and Quality. Producing national HCUP estimates\u2014kids\u2019 inpatient database (KID). Published December 13, 2018. Accessed January 27, 2023. https:\/\/www.hcup-us.ahrq.gov\/tech_assist\/nationalestimates\/508_course\/508course_2018.jsp#kid"},{"key":"eoi230013r20","doi-asserted-by":"crossref","unstructured":"Martin? JA, Hamilton? BE, Osterman? MJK. Births in the United States, 2021. Accessed February 10, 2023. https:\/\/stacks.cdc.gov\/view\/cdc\/119632","DOI":"10.15620\/cdc:119632"}],"container-title":["JAMA Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaophthalmology\/articlepdf\/2803759\/jamaophthalmology_bhatnagar_2023_oi_230013_1684088995.36031.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T15:04:32Z","timestamp":1684422272000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaophthalmology\/fullarticle\/2803759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaophthalmol.2023.0809","relation":{},"ISSN":["2168-6165"],"issn-type":[{"value":"2168-6165","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}