Role of Birth Order in the Development of Retinopathy of Prematurity in Multiple Gestation: a Study of 1040 Asian Indian Premature Infants

To evaluate the role of birth order in the development of retinopathy of prematurity (ROP) in Asian Indian infants of multiple gestations. A total of 1257 infants born from multiple gestations, screened for ROP between January 2011 to December 2017 under the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program, were included. The online database of a detailed demographic and clinical record was used for the analysis. Details of postnatal interventions like use of supplemental oxygen, neonatal diseases, congenital heart diseases, phototherapy, and plurality (twins or triplets) were noted. The data was analysed to compare the distribution of ROP and risk factors across the plurality of birth. Of the 1257 infants, 1040 (82.7%) with complete data were included for the analysis. The mean BW of the study cohort was 1605 g (95% CI, 1583–1628 g) and the mean GA was 32.8 weeks (95% CI, 32.7–33.0 weeks). Of the 1040 infants, 719 infants (69.13%) had no ROP and 321 (30.87%) had any stage ROP. Any ROP was seen in 30.80% of first born, 31.00% of second born, and 30.8% of the third born, but this was not statistically significant. Type 1 ROP was seen in 6.3% of first born, 7.5% of second born, and in none of the third born. The incidence of ROP among multiple gestations seems to be dependent on birth weight, irrespective of the birth order. A normal screening protocol used for singleton infants should suffice for infants born out of plurality.