Characteristics of babies with unstable clinical course screened for retinopathy of prematurity

The medical records of 2,457 infants screened and staged for retinopathy of prematurity (ROP) at the University of Colorado Hospital and Children's Hospital Colorado between 2006 and 2021 were reviewed to identify those with "unstable clinical course," that is, babies who did not meet the published birthweight (BW) or gestational age (GA) screening criteria but for whom an ROP examination was requested by the treating neonatologist. A total of 146 infants (5.9%) with unstable clinical course were identified and found to be similar to infants meeting the BW/GA criteria for ROP screening in terms of sex, race/ethnicity, and singleton/multiple birth. Four of the unstable clinical course babies (2.7%) developed mild ROP; none developed type 1 or type 2 ROP. Rates of ROP were higher among babies meeting the BW/GA criteria, in which 6.9% developed type 1, 6.2% type 2, and 22.2% mild ROP (P < 0.0001). Overall, infants with unstable clinical course and screened for ROP did not develop treatment-requiring ROP.