Retinopathy of prematurity in India: incidence, risk factors, outcome and the applicability of current screening criteria

Abstract

Background: To study the incidence, risk factors and outcome of retinopathy of prematurity (ROP) in at-risk newborns at tertiary care hospital in Vadodara.Methods: Preterm infants with birth weight ≤2000 gm and gestation ≤34 weeks were screened for ROP at 4 weeks of birth for first screening or if <28 week or <1200 grams then at 3 weeks after delivery. Infants with birth weight >2000 gm and gestation >34 weeks were screened only if they had additional risk factors. Those found to have high risk ROP were treated.Results: The incidence of ROP in 286 infants who were screened was 24.1%, 12 ROP positive cases were having birth weight >2000 gm. On multivariate analysis risk factors predisposing to ROP (P<0.05) were birth asphyxia, Sepsis, multiple blood transfusion, respiratory distress syndrome, multiple birth, antenatal steroid use and Phototherapy. Out of 69 infants who developed ROP, 6(8.7%) needed invasive management.Conclusions: Risk factors predisposing to ROP were gestational age and birth weight alone and along with the various risk factors like birth asphyxia, sepsis, multiple blood transfusion, respiratory distress syndrome, multiple birth, antenatal steroid use and phototherapy. The occurrence of ROP is trending towards a rise including newborns with higher birth weight and gestational age in developing countries; hence necessitating to use different guideline for Screening of Newborns in these developing countries.