Jiangya Wang,1 Qingmin Ma,2 Fangfang Du1 

1Department of Pediatrics, Hebei General Hospital, Shijiazhuang, 050000, People’s Republic of China; 2Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, 050000, People’s Republic of China

Correspondence: Jiangya Wang, Department of Pediatrics, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050000, People’s Republic of China, Tel +86 18330181686, Email wjiangya_wjy@126.com

Background: Retinopathy of prematurity (ROP) is rising in China alongside improved neonatal intensive care. Current screening, reliant on gestational age (GA) and birth weight (BW), faces challenges of resource constraints and infant burden. Postnatal weight gain rate (WGR) is a potential predictive marker, but robust data on its value, particularly for severe ROP, and validated thresholds within the Chinese population are lacking. The study aimed to examine the risk factors linked with the incidence of retinopathy of ROP.
Methods: A retrospective cohort analysis was conducted on 230 preterm infants (GA ≤ 32 weeks, BW ≤ 2000g) admitted to a neonatal intensive care unit (2016– 2020). Infants were categorized into non-ROP (n=189) and ROP (n=41) groups; the ROP group was further stratified into mild (n=32) and severe (n=9) subgroups. Clinical data, including GA, BW, comorbidities and WGR, were analyzed. Univariate analysis, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were employed.
Results: In the univariate analysis, the non-ROP group manifested superior values in GA, BW, and rates of weight gain in comparison to the ROP group (all P < 0.05). Multivariate analysis identified lower GA (OR=0.91, 95% CI=0.83– 0.99, P=0.03), lower BW (OR=0.99, 95% CI=0.99– 1.00, P=0.04), and lower WGR (OR=0.73, 95% CI=0.63– 0.83, P< 0.01) as independent risk factors for ROP. GA, BW, and WGR were significantly higher in the mild vs severe ROP group (all P< 0.05). ROC analysis demonstrated that WGR < 24.5 g/day predicted any ROP (AUC=0.939, 95% CI=0.905– 0.973, sensitivity 90.2%, specificity 86.8%, P< 0.05). Crucially, WGR < 18 g/day predicted severe ROP (AUC=0.865, 95% CI=0.70– 1.00, sensitivity 100%, specificity 66,7%, P< 0.05).
Conclusion: Diminished GA, reduced BW, and sluggish weight gain rates have been correlated with an elevated susceptibility to ROP. Notably, a diminished rate of weight gain can serve as an anticipatory marker for severe ROP, given its heightened propensity to precipitate the onset of severe ROP.
Trial Registration: Full name of the registry: Chinese Clinical Trial Registry, http://www.chictr.org.cn. Trial registration number: chiCTR2400087938. Date of registration: 2024-08-07.

Keywords: birth weight, gestational age, retinopathy of prematurity, risk factors, weight gain rate