Incidence and risk factors of retinopathy of prematurity in artificial reproductive technology conceived preterm infants in China

To evaluate the incidence and associated risk factors of retinopathy of prematurity (ROP) in preterm infants conceived through assisted reproductive technology (ART) in China. We conducted a retrospective analysis of preterm infants who were hospitalized between August 2019 and December 2024. Infants were divided into two groups based on mode of conception: ART-conceived and naturally conceived. The incidence of ROP was compared between the groups. Clinical data were collected for both the infants and their mothers. A total of 1,019 preterm infants were included, comprising 195 ART-conceived and 824 naturally conceived infants. ROP was diagnosed in 33 ART-conceived (16.9%) and 136 naturally conceived infants (16.5%), with no statistically significant difference between the two groups (P = 0.888). Similarly, no significant difference was observed in ROP staging (P = 0.228). Multivariable logistic regression analysis showed that, in the ART-conceived group, greater gestational age (OR: 0.618) and a history of antenatal corticosteroid use (OR: 0.278) were protective factors, whereas apnea of prematurity (OR: 3.170) increased the risk of ROP. Similarly, in the naturally conceived group, greater gestational age (OR: 0.840) was also a protective factor, while apnea of prematurity (OR: 1.666) increased the risk of ROP. The incidence of ROP did not differ significantly between ART-conceived and naturally conceived preterm infants. In ART-conceived infants, higher gestational age and a history of antenatal corticosteroid use were protective factors, whereas apnea of prematurity increased the risk of ROP.