Incidence and Risk Factors Of Retinopathy Of Prematurity In Multicenter Neonatal Intensive Care Unit Patients

Abstract

Background: Retinopathy of prematurity (ROP) poses a significant risk in the management of premature infants, potentially resulting in blindness if not promptly identified and addressed.

Objective: To determine the incidence of retinopathy of prematurity among newborns in multiple neonatal intensive care units (NICUs), pinpoint the associated risk factors, and evaluate the outcomes of such cases.

Materials and Methods: A prospective observational study was done at the neonatal ICUs of Akbar Niazi Teaching Hospital, Islamabad, PAEC Hospital, Islamabad and Holy Family Hospital, Rawalpindi between April 2022 to December 2023.A birth occurring at gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Infants with gestational age exceeding32 weeks or birth weight surpassing1500 g were considered eligible for inclusion if oxygen therapy exceeding 7 days. Total350 infants underwent retinal examination through indirect ophthalmoscope from fourth week after birth, with subsequent follow-ups.

Results: Among350infants; 5.1% (n=18) were diagnosed with ROP in either one or both eyes. The classification revealed55.6% (n=10) at stage 1, 27.8% (n=5)at stage 2, and 16.7% (n=3) at stage-3. There was no reported case Winthrop at stage-4 or 5.Laser ablative therapy was administered to three cases with stage-3 ROP. In univariate analysis notable relation was observed between the incidence of ROP and factors such as gestational age (p = 0.0001), sepsis (p = 0.002), oxygen therapy (p = 0.0001), and blood transfusion rate (p = 0.002).Following logistic regression, gestational age, sepsis, oxygen therapy, and blood transfusion rate continued to be significant.

Conclusion: The ROP incidence was low, with low gestational age, sepsis, oxygen therapy, and reduced blood transfusion rate identified as significant risk factors.