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

Objectives: To determine the prevalence and predictors of Retinopathy of prematurity (ROP) and severe ROP. Methods: A 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. Results: A 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. Conclusion: The 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.