Long-term refractive status of preterm infants from singleton and multiple pregnancies ^*

Objective: To study the effect of plurality on refractive status in former preterm infants at age 8–12 years. Methods: Refraction was compared in singletons and multiples, in very low birth weight infants (VLBW, <1500 g) at age 6 months and 8–12 years. Preterm infants were compared with a group of term infants. Results: Thirty-seven of 104 (36%) VLBW infants were multiples. Comparison of refraction between singletons and multiples revealed no difference at age 6 months, while at age 8–12 years, multiples had significantly more refractive errors (singletons 28% versus multiples 54% p = 0.01), particularly myopia. In preterms, refractive status at age 6 months and multiple birth were significant predictors of refraction at 8–12 years, while birth weight (BW) and retinopathy of prematurity (ROP) were not predictive. Refractive errors were significantly more common in preterms (37%) than in term-born children (14%) (p = 0.0002). Overall, refraction moved from predominantly hyperopic at 6 months to normal or myopic at age 8–12 years in preterm. Conclusions: Multiple gestation in preterms is associated with increased risk for refractive errors, particularly myopia in childhood. Refraction in preterms during childhood progresses from hyperopia to myopia. Former preterms have more refractive errors than children born at term-born children.