Retinopathy of prematurity in preterm infants: A prospective study of prevalence and predictors in Northern India

Abstract

ObjectivesTo determine the prevalence and predictors of Retinopathy of prematurity (ROP) and severe ROP. MethodsA prospective observational study (April 2019–May 2020) was conducted at a tertiary care center in preterm newborns with; 1) birth-weight <2000 g or gestation <34 weeks and 2) gestation 34–36 weeks with risk factors that predispose to ROP. ResultsA total of 340 preterm newborns were screened. ROP was diagnosed in 63 (18.5%), of which 8 (2.4%) had severe ROP. 30.2%, 63.5%, and 9.5% babies had stage 1, 2, and 3 ROP, respectively. Perinatal risk factors for ROP were assessed using univariate analysis. In the binary logistic regression analysis, birth-weight<1250 g, gestation<30 weeks, weight-gain proportion at 4, 5 and 6 weeks, respiratory distress syndrome (RDS), surfactant administration, need for oxygen were significantly associated with ROP while birth-weight<1250 g, apnea, surfactant administration and oxygen duration≥80 h were associated with severe ROP (p < 0.005). Infants with poor postnatal weight-gain were found to be at risk for ROP. ROC plot depicted an absolute weight gain of 535 g at 6-weeks of age had a sensitivity of 58.7% and specificity of 32.9% for predicting ROP. ConclusionThe prevalence of ROP was 18.5%. Birth-weight<1250 g, gestation <30 weeks, weight-gain proportion at 4, 5 and 6 weeks, RDS, surfactant administration, need for oxygen were independent predictors for ROP, however birth-weight<1250 g, apnea, surfactant administration and oxygen duration ≥80 h were independent predictors for severe ROP. Preterm newborns with poor postnatal weight-gain are at risk for ROP.