Abstract
Purpose :
The Postnatal Growth and ROP Studies (G-ROP-1&2) developed new ROP screening criteria with 100% sensitivity for type 1 and 30% fewer infants requiring exams. However, the criteria are slightly less sensitive for type 2. Currently under conventional screening criteria, outlier infants are identified with a subjective criterion of neonatologist judgment of a “poor postnatal course.” We identified risk factors for developing stage 2 and 3 in infants who were older, larger, or had faster weight gain than the G-ROP criteria to help neonatologists identify these outlying infants.
Methods :
Secondary analysis of 2312 of 7483 infants in G-ROP-1 who did not meet the proposed G-ROP criteria. 5(0.2%) had stage 3; 57(2.5%) had stage 2. Medical and surgical comorbidities of prematurity during the first 28 postnatal days were evaluated using multivariable analysis.
Results :
Factors associated with stage 2 or 3 ROP were no enteral feeding in first 3 weeks (aOR 5.6, 95% CI 2.6-12.1; 9 or more days on supplemental oxygen in first 4 weeks (aOR3.34, 2.0-5.6); NEC (aOR 4.2, 1.0-17.5); and IVH grade III/IV (aOR 2.6, 0.9-7.6). Risk of stage 2 or 3 increased with number of risk factors: 20/1575(1%) for 0; 34/636(5%) for 1; 7/51(14%) for 2; 1/3(33%) for 3.
Conclusions :
NEC, IVH grade III/IV, 9 or more days on supplemental oxygen in first 4 weeks, and no enteral feeding in first 3 weeks are associated with increasing risk of stage 2 or 3 ROP. Counting the number of factors may help identify outlier infants requiring ROP examinations.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.