Risk Factors for Developing Treatment-Requiring Retinopathy of Prematurity: A Retrospective Study from a Single Center

Abstract

Background: Retinopathy of prematurity (ROP) is a significant cause of childhood blindness, primarily affecting preterm infants. The condition's incidence and severity are influenced by various factors, including gestational age, birth weight, and neonatal care practices. Early identification of risk factors associated with treatment-requiring ROP is crucial for timely intervention and prevention of severe outcomes.

Aim: To identify the risk factors associated with the development of treatment-requiring ROP in neonates admitted to a tertiary care NICU, providing insights to enhance early detection and managements strategies.

Methods: A total of 52 neonates who developed ROP were included in the study. Data on maternal, perinatal, and neonatal characteristics were collected and analyzed to identify risk factors for treatment-requiring ROP. Statistical analyses were performed using SPSS version 16, with p-values less than 0.05 considered significant.

Results: Of the 52 neonates included, 18 (34.6%) required treatment for ROP. Lower gestational age (mean 28 ± 1.8 weeks) and lower birth weight (mean 1091 ± 246 grams) were significantly associated with treatment-requiring ROP. Antenatal steroid administration showed a protective effect, while prolonged non-invasive ventilation, total parenteral nutrition, and conditions such as respiratory distress syndrome (RDS) and necrotizing enterocolitis (NEC) were identified as significant risk factors. The majority of treated cases (72.2%) underwent laser photocoagulation.

Conclusion: Lower gestational age, lower birth weight, prolonged respiratory support, and certain neonatal comorbidities are significant risk factors for treatment-requiring ROP. Antenatal steroids were found to be protective. Early identification and management of these risk factors are essential to prevent the progression of ROP to severe stages requiring treatment.

Recommendations: The study recommends enhanced monitoring of neonates with identified risk factors, especially those with low birth weight and gestational age. Implementing strict oxygen therapy protocols and promoting the use of antenatal steroids in eligible mothers can help reduce the incidence of severe ROP.