Incidence and Risk Factors for Rop Development in Babies Admitted In Nicu Outborn and Inborn In A Tertiary Care Center andAssociation of Anemia in Newborns with ROP

Abstract

 Background: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness, particularly in India, where high preterm birth rates and expanding neonatal intensive care services contribute to a growing disease burden.

Objectives: To determine the incidence of ROP among neonates admitted to inborn and outborn NICUs of a tertiary care hospital in Assam, and to evaluate risk factors.

Methods: A prospective observational study was conducted at Gauhati Medical College and Hospital from October 2022 to August 2023. Neonates with birth weight <2000 g, gestational age <34 weeks, or 34–36 weeks with additional risk factors were included. Ophthalmic screening with indirect ophthalmoscopy was performed at 3–4 weeks of age and classified according to the International Classification of ROP. Clinical data and neonatal morbidities were analyzed using Chi-square test and logistic regression.

Results: Of 300 infants screened, 62 developed ROP, giving an incidence of 20.7%. Incidence was higher in males (56.7%) and inversely related to gestational age (80% at 31 weeks vs. 6.1% at ≥37 weeks) and birth weight (77.7% <1000 g vs. 7.7% >2500 g) (p<0.001). Prolonged oxygen exposure (>3 days) markedly increased risk (63.9% vs. 4.1%, p<0.001). Independent predictors included phototherapy (OR 13.79), birth asphyxia (OR 11.28), sepsis (OR 4.80), multiple transfusions (OR 5.73), respiratory distress syndrome (OR 3.62), and multiple births (OR 3.32), while antenatal steroid use was protective (OR 0.19). Most cases (91.3%) regressed spontaneously; 6 infants (9.7%) required treatment.

Conclusion:

ROP incidence in this cohort was substantial, emphasizing the need for universal screening of high-risk neonates, stringent oxygen monitoring, and judicious transfusion practices to reduce preventable blindness