FREQUENCY AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN PRETERM BABIES OF TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY

Abstract

Background: Retinopathy of prematurity (ROP) is a potentially preventable cause of childhood blindness that primarily affects preterm neonates with immature retinal vasculature. Improvements in neonatal survival have increased the population at risk, particularly in middle-income countries where standardized screening and optimal neonatal care may not be uniformly implemented. Identifying local prevalence and contributory risk factors is essential for developing effective screening strategies and reducing avoidable visual morbidity in this vulnerable population.

Objective: To determine the prevalence of retinopathy of prematurity and identify associated neonatal and maternal risk factors among preterm neonates admitted to a tertiary care hospital.

Methods: This retrospective cross-sectional study was conducted in the Neonatal Intensive Care Unit of Combined Military Hospital, Kharian. Preterm neonates with a gestational age of ≤34 weeks and/or birth weight ≤1500 g were included. Clinical records were reviewed to extract neonatal variables, including gestational age, birth weight, APGAR scores, oxygen therapy, mechanical ventilation, and comorbidities, as well as maternal risk factors. Ophthalmological screening was performed using indirect ophthalmoscopy, and ROP was classified according to international guidelines. Data were analyzed using SPSS version 26.0. Associations were assessed using the Chi-square test, with a p-value <0.05 considered statistically significant.

Results: Among 188 preterm neonates, 35 developed ROP, yielding a prevalence of 18.7%. A significantly higher proportion of ROP was observed in neonates with gestational age ≤30 weeks (71.4%, p = 0.03) and birth weight ≤1000 g (57.1%, p = 0.05). Prolonged oxygen therapy exceeding seven days (68.6%, p <0.001), mechanical ventilation (62.9%, p <0.001), low APGAR score at five minutes (48.6%, p = 0.01), and bronchopulmonary dysplasia (37.1%, p <0.001) were strongly associated with ROP. Patent ductus arteriosus was also more frequent among affected neonates.

Conclusion: Retinopathy of prematurity remains a significant concern among preterm neonates, particularly those with extreme prematurity, low birth weight, and intensive respiratory support. Early screening, optimized neonatal care, and timely intervention are critical to reducing ROP-related visual impairment.