Risk Factors and Outcomes of Retinopathy of Prematurity among Preterm Neonates in a Tertiary Care NICU

Retinopathy of Prematurity (ROP) is a significant cause of visual impairment in premature infants worldwide. In Bangladesh, increasing survival rates of preterm infants highlight the urgency of ROP screening and treatment. Early detection and intervention are crucial to prevent blindness and improve outcomes for affected children in both contexts. We aimed to identify the prenatal risk factors for ROP admission to the Institute of Child and Mother Health's NICU. Retinopathy of Prematurity (ROP) is a multifactorial condition affecting premature infants, with significant associations with gestational age, birth weight, and maternal, and perinatal risk factors. This study analyzed the incidence, risk factors, and outcomes of ROP among neonates. Infants with ROP had significantly lower gestational age (32.89 ± 2.24 weeks vs. 34.37 ± 1.68 weeks, p = 0.001) and birth weight (1291.27 ± 419.41 g vs. 1744.63 ± 429.89 g, p < 0.001) compared to those without ROP. Maternal risk factors such as antepartum hemorrhage (APH, p = 0.03) and prolonged rupture of membranes (p = 0.007) were significantly associated with ROP, with odds ratios of 5.561 (95% CI: 1.276-24.228) and 4.518 (95% CI: 1.654-12.340), respectively. Among perinatal factors, apnea emerged as the most significant risk factor (OR: 4.348, 95% CI: 1.077-17.552), while sepsis, respiratory distress syndrome (RDS), and blood transfusions were also more prevalent in infants with ROP (p < 0.05). Outcomes for infants with ROP included spontaneous regression in 31/55 cases, while 23/55 required intervention. Post-treatment complications were reported in 15 cases (65.21%), with refractive errors (52.17%) and squint (13.04%) being the most common. These findings emphasize the importance of monitoring maternal and perinatal risk factors, particularly APH and apnea, to identify at-risk infants. Early intervention and follow-up are crucial to managing ROP and its complications and improving outcomes for affected neonates.