Timing and Substrate of Enteral Feeding as Risk Factors for Developing Retinopathy of Prematurity

Objective: Enteral feeding has advantages over parenteral nutrition, so the objective is to evaluate the effects of timing and substrate of enteral feeding on the risk of developing retinopathy of prematurity (ROP). Study Design: Retrospective cohort study of 7,483 premature infants undergoing ROP examinations at 29 North American and Canadian hospitals, 2006–2012 (The G-ROP Study). Multivariable regression evaluated associations between enteral feeding by week of life and any or severe ROP, adjusting for birth weight and gestational age. Results: 3,224 (43.1%) had ROP and 931(12.4%) severe ROP. Compared to no enteral feeding, any enteral feeding was independently protective for ROP in all weeks 1–6; odds ratios 0.50–0.74 (P <.0001 to P <.02) for any ROP and 0.43–0.59 (P <.02 to P =.0001) for SEVERE ROP. Conclusion: In this cohort, any substrate of enteral feeding during each of the first SIX weeks of life was associated with lower odds of ROP and severe ROP.