INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN BABIES WEIGHING <1800 G; WITH SPECIAL REFERENCE TO THE BABIES WEIGHING BETWEEN 1501 G & 1800 G: A CLINICAL STUDY IN A TERTIARY CARE HOSPITAL

Abstract

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the developing retina and a leading cause of preventable blindness in infants. With improving neonatal intensive care in developing countries, the incidence of ROP in infants with relatively higher birth weights, including the 1501–1800 g range, is increasingly recognized. Data specific to this weight category from eastern India are limited. Objective: To determine the incidence of ROP and identify associated perinatal and neonatal risk factors among infants weighing less than 1800 g, with special reference to the 1501–1800 g subgroup, in a tertiary care hospital. Methods: A prospective, observational, hospital-based study was conducted over 12 months (March 2019 – February 2020) at the ROP clinic of Nil Ratan Sircar Medical College and Hospital, Kolkata. Two hundred preterm infants with birth weight <1800 g underwent serial ophthalmic examinations using binocular indirect ophthalmoscopy. Data on oxygen exposure, metabolic parameters, perinatal variables, and neonatal morbidities were recorded and analyzed using Student's t-test, chi-square/Fisher's exact test, and multivariate logistic regression (SPSS v26.0). Results: ROP was detected in 56 of 200 infants (28.0%). In the 1501–1800 g subgroup, 26 of 105 infants (24.76%) developed ROP. Stages 1 and 2 accounted for 89.3% of cases; no infant had plus disease or aggressive posterior ROP. Significant risk factors included oxygen therapy (higher maximum SpO₂, lower minimum SpO₂, longer duration), hyperglycemia, low APGAR scores at 1 and 5 minutes, respiratory distress syndrome, apnea of prematurity, septicemia, anemia, and need for blood transfusion (all p<0.05). Surfactant therapy, necrotizing enterocolitis, intraventricular hemorrhage, patent ductus arteriosus, and maternal factors were not significantly associated. Conclusion: ROP affects a clinically significant proportion of infants weighing 1501–1800 g, a group currently excluded from standard screening guidelines. Oxygen management, metabolic stability, and vigilant NICU monitoring are the most modifiable preventive targets. Screening protocols in similar resource settings should consider extending the birth weight threshold to include this weight category.