Evaluation of risk factors and assessment of socio-demographic factors affecting retinopathy of prematurity in a tertiary care centre of central India

Abstract

Aim: Retinopathy of prematurity is a multifactorial vasoproliferative disease whose incidence increases with a decrease in gestational age. It is characterized by the development of abnormal blood vessels in the premature infant's developing retina due to incomplete vascularization of the retinal tissue brought on by hyperoxia, which also causes endothelial cell death and VEGF (vascular endothelial growth factor) downregulation. We targeted to study the Risk factors and assess the socio-demographic factors affecting retinopathy of prematurity in the population of central India. Materials and Methods: This study was conducted in A tertiary care eye center in central India from March 2020 to March 2021. The Institutional Review Board approved the study, and informed consent was obtained from all the subjects' parents before participating. Some of the consents were taken in the local language to ensure validity. The patients' parents were free to withdraw from the study and were assured that their withdrawal would not affect the quality of the care provided to their children. Patients (infants) with a history of preterm birth come to the outpatient. Results: The most prevalent risk factor associated with ROP in our study was Prolonged exposure to Oxygen (>7 days), followed by sepsis and RDS. The risk factors that showed a statistically significant association with ROP were Prolonged Oxygen exposure, RDS, Sepsis, Fungal sepsis, and IUGR. Twin birth, Anemia, Blood Transfusion, Neonatal Jaundice, Phototherapy, and ABO Incompatibility were also associated with ROP, but the association was not statistically significant. (P > 0.05). In our study, among the preterms who had ROP, male children accounted for 46.4%, while females were 53.4%. The association between the gender of the neonate and the occurrence of ROP was found to be non-significant. (P > 0.05). In our study, among the preterms who had ROP, male children accounted for 46.4%, while females were 53.4%. The association between the gender of the neonate and the occurrence of ROP was found to be non-significant. (P > 0.05). Most of the neonates with ROP in our study were of the gestational age of 29-32 weeks. (48.9%) The association between the child's gestational age and the occurrence of ROP was found to be statistically significant. (P = 0.001, P < 0.05). Conclusion: The incidence of ROP has been on the rise over the years due to the advancements and improvements in the management of preterm neonates in the NICU which have drastically improved the survival of these high-risk neonates which earlier often succumbed to various complications related to premature birth. This has presented as a challenging and uphill task to screen, diagnose and treat neonates who are at risk and develop Retinopathy of Prematurity so that ROP-related blindness can be prevented.

Keywords

• central india
• low birth weight
• retinopathy of prematurity