Author’s Disclosure Block: Farnaz Javadian, none; Wilma Hopman, none; Faiza Khurshid, none; Christine Law, none

Abstract Body
Purpose: Steroid treatment can be crucial in treating morbidity and mortality in preterm infants. The literature describes differing effects of antenatal (ANS) versus postnatal steroids (PCS) in the development of retinopathy of prematurity (ROP). In this study, we investigate the relationship of steroid use on the development of ROP in Canadian neonates. Study Design: This is an ethics-approved retrospective cohort study. Methods: Data were obtained from the Canadian Neonatal Network (CNN), a national database of all 32 level III neonatal intensive care units (NICUs) in Canada. A total of 20,255 neonates met the inclusion criteria, with admission to a CNN NICU under the gestational age of 30+6 weeks or less than 1250 g, with ROP screening. Unadjusted and adjusted odds ratios based on confounders from conditional logistic regression were determined for the risk of developing any ROP, type 1 ROP, and non-type 1 ROP depending on ANS and PCS use. Results: Neonates receiving only PCS had the greatest risk of type 1 ROP, with an adjusted odds ratio of 3.48 (1.94, 6.23), followed by neonates receiving both ANS and PCS with an adjusted odds ratio of 2.9 (1.64, 5.13), suggesting a protective effect of ANS. Neonates that received neither ANS nor PCS had an adjusted odds ratio of 1.57 (0.76, 3.25). Conclusions: This is the first large-scale national retrospective review examining the effect of both ANS and PCS on the development of ROP. PCS has a stronger association in the development of type 1 ROP, with a possible protective effect of ANS in Canadian neonates.