Retinopathy of prematurity in late preterm and early term neonates: Incidence and risk factors in a prospective cohort

BackgroundThe predominant risk factors and outcomes of ROP in neonates with more than 34 weeks of gestation are not well described in low- and middle-income countries despite higher incidence of ROP in these neonates.ObjectivesTo determine the incidence and risk factors of ROP in neonates between 34 weeks and 38 weeks 6 days.Material and MethodsWe conducted a prospective observational study in a tertiary care paediatric hospital from January 2020 to June 2021. Neonates with gestational age between 34 and 38 weeks 6 days were included. Standardized screening protocols were adapted, with data on demographic characteristics, risk factors, ROP findings, and treatment collected systematically.ResultsAmong 267 neonates, 224 underwent ROP screening. Fifteen (6.7%) neonates had any ROP, with 6 (2.6%) having Type I ROP requiring treatment. Among the cohort, higher proportions of late preterm neonates had ROP 12 (8.5%) compared to early term neonates 3 (3.6%) and amongst the neonates who required treatment, 6 (2.6%) all were late preterm neonates. Significant risk factors for ROP development included being small for gestational age [12 (80%) versus 58 (28%), <i>p</i> < 0.01], postnatal weight gain [Mean Difference: 9.8 gm/kg/day; 95% CI, 6.7 - 13.0, <i>p</i> < 0.001] and associated comorbidities such as respiratory support [15 (100%) versus 128 (61%), <i>p</i> < 0.01], shock [13 (86.7%) versus 118 (56.5%), <i>p</i> < 0.01] and sepsis [3 (20% vs 22 (10%); <i>p</i> < 0.01].ConclusionsOur study supports extending ROP screening to neonates ≥34 weeks with growth restriction or comorbidities, particularly in low- and middle-income settings.