Prevalence and risk factors of retinopathy of prematurity among preterm neonates admitted to a tertiary care hospital

Authors

  • Mohammad M. Rahman Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
  • Mohammad A. Adnan Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
  • Muhammad G. Uddin Department of Pediatrics, BITID, Chattogram, Bangladesh
  • Mohammad A. Haque Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
  • Mahbub Ahmed Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
  • Mohammad T. Islam Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260395

Keywords:

Retinopathy of prematurity, Neonate, Vitamin E, SGA

Abstract

Background: Retinopathy of prematurity is a multifactorial vaso-proliferative disorder of the retina affecting mainly premature neonates. We aimed to determine the prevalence of ROP as well as to find out the risk factors behind this.

Methods: This cross-sectional analytic study was conducted in the department of neonatology and obstetrics and gynecology of BSMMU, Dhaka, from April 2016 to September 2017. All stable term and stable preterm newborns of both sexes were enrolled. Hemodynamically unstable newborn babies, newborns with congenital anomalies, newborns of<30 weeks, and newborns admitted after 72 hours of age were excluded. 70 samples comprising into two groups, in preterm group 40 and in term group 30 samples were taken. Plasma tocopherol <500 mg/dl was used as a deficient vit-E level. ROP screening was done by an ophthalmologist using a binocular indirect ophthalmoscope.

Results: Among 40 pre-term neonates, 12 were diagnosed as ROP with a prevalence of 30%. Stage 1-3 ROP were present among 8, 2 and 2 cases, respectively. There were equal number of males and females (35 each). Deficient vit-E level and SGA were significantly associated with ROP (p=0.05 and p=0.01, respectively). Stepwise multiple logistic regressions of risk factors showed vitamin E deficiency as a significant risk of developing ROP when other risk factors are intercepted.

Conclusions: Prevalence of ROP was 30% among pre-term neonates. Deficient vit-E level and SGA were significantly associated with ROP. Vitamin E deficiency resulted significant risk of developing ROP when other risk factors are present.

Metrics

Metrics Loading ...

References

Ahmed AS, Muslima H, Anwar KS, Khan NZ, Chowdhury MA, Saha SK, et al. Retinopathy of prematurity in Bangladeshi neonates. J Trop Pediat. 2008;54(5):333-9. DOI: https://doi.org/10.1093/tropej/fmn035

Preterm birth. 2024. Available at: https://www.hudson.org.au/disease/womens-newborn-health/preterm-birth/. Accessed on 15 January 2025.

Shah PK. Retinopathy of prematurity: Past, present, and future. World J Clin Pediat. 2016;5(1):35. DOI: https://doi.org/10.5409/wjcp.v5.i1.35

Smith LEH. Pathogenesis of retinopathy of prematurity. Growth Hormone; IGF Research. 2004;14:140-4. DOI: https://doi.org/10.1016/j.ghir.2004.03.030

McColum JR, Fleck BW. Retinopathy of prematurity: Causation. Sem Neonatol. 2001;6(6):453-60. DOI: https://doi.org/10.1053/siny.2001.0079

Shan RS, Rajalakshmi R, Bhatt RV, Hazra MN, Patel BC, Swamy NB, et al. Vitamin E status of the newborn in relation to gestational age, birth weight, and maternal vitamin E status. Brit J Nutrit. 1987;58(2):191-8. DOI: https://doi.org/10.1079/BJN19870086

Kositamongkol S, Suthutvoravut U, Chongviriyaphan N, Feungpean B, Nuntnarumit P. Vitamin A and E status in very low birth weight infants. J Perinatol. 2011;31(7):471-6. DOI: https://doi.org/10.1038/jp.2010.155

Hakeem AH, Mohamed GB, Othman MF. Retinopathy of prematurity: a study of prevalence and risk factors. Middle East Afr J Ophthalmol. 2012;19(3):289-94. DOI: https://doi.org/10.4103/0974-9233.97927

Taqui AM, Syed R, Chadry TA. Retinopathy of prematurity: Frequency and risk factors in a tertiary care hospital in Karachi, Pakistan. J Pak Med Assoc. 2008;58(4):186-90.

Shah VA, Yeo CL, Ling YL. Incidence and risk factors of retinopathy of prematurity among very low birth weight infants in Singapore. Ann Acad Med Singapore. 2005;34(2):169-78. DOI: https://doi.org/10.47102/annals-acadmedsg.V34N2p169

Murthy KR, Nagendra BK. Analysis of risk factors for the development of ROP in preterm infants at a tertiary referral hospital in South India. Acta Medica Lituanica. 2006;13:147-51.

Baydas G, Karatas F, Gursu MF, Bozkurt HA, Ilhan N, Yasar A, et al. Antioxidant vitamin levels in term and preterm infants and their relation to maternal vitamin status. Arch Med Res. 2002;33(3):276-80. DOI: https://doi.org/10.1016/S0188-4409(02)00356-9

Kumar A, Ranjan R, Basu S, Khanna HD, Bhargava V. Antioxidant levels in cord blood of low birth weight newborns. Indian Pediatr. 2008;45(7):583-5.

Gawai D, Vaishali U, Bhaskar K. Incidence and risk factors of retinopathy of prematurity in Tertiary Care Centre of Western India. J Med Sci Clin Res. 2016;4(7):11472-6. DOI: https://doi.org/10.18535/jmscr/v4i7.48

Adenuga O, Ahuja A, Reddy VY, Kewlani D, Ravindran M, Ramakrishnan R. Risk factors for retinopathy of prematurity in a district in South India: A prospective cohort study. Oman J Ophthalmol. 2018;11(1):33. DOI: https://doi.org/10.4103/ojo.OJO_97_2016

Perubil S. Risk factors in retinopathy of prematurity. ISRCTN registry. 2016. DOI: https://doi.org/10.1186/ISRCTN15382580

Al-Essa M, Azad RV, Rashwan N. Threshold stage of retinopathy of prematurity: maternal and neonatal risk factors. Ann Saudi Med. 2000;20:129-31. DOI: https://doi.org/10.5144/0256-4947.2000.129

Araz-Ersan B, Kir N, Akarcay K. Epidemiological analysis of retinopathy of prematurity in a referral centre in Turkey. Brit J Ophthalmol. 2013;97:15-7. DOI: https://doi.org/10.1136/bjophthalmol-2011-301411

Thomas K, Shah PS, Canning R. Retinopathy of prematurity: Risk factors and variability in Canadian neonatal intensive care units. J Neonatal Perinatal Med 2015;8(3):207-14. DOI: https://doi.org/10.3233/NPM-15814128

Sabzehei MK, Afjeh SA, Dastjani Farahani A, Ahmad RS, Fatemeh E. Retinopathy of prematurity: incidence, risk factors, and outcome. Arch Iran Med 2013;16(9):507-12.

Lin HJ, Lin CC, Tsai SW, Horg-Chin L, Bai-Horng S. Risk factors for retinopathy of prematurity in very low birth-weight infants. J Chin Med Assoc 2003;66(11):662-8.

Edwards G, Olson CG, Euritt CP, Koulen P. Molecular Mechanisms Underlying the Therapeutic Role of Vitamin E in Age-Related Macular Degeneration. Front Neurosci. 2022;16:890021. DOI: https://doi.org/10.3389/fnins.2022.890021

Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity. Arch Ophthalmol. 2003;121(12):1684. DOI: https://doi.org/10.1001/archopht.121.12.1684

Shohat M, Reisner SH, Krikler R, Nissenkorn I, Yassur Y, Ben-Sira I. Retinopathy of prematurity: Incidence and risk factors. Pediatrics. 1983;72(2):159-63. DOI: https://doi.org/10.1542/peds.72.2.159

Akter S, Hossain MM, Shirin M, Khalil I, Anwar KS. Blood transfusion: A risk factor in retinopathy of prematurity. Bang J Child Health. 2012;34(2):38-43. DOI: https://doi.org/10.3329/bjch.v34i2.10215

Yang C-Y. Analysis of incidence and risk factors of retinopathy of prematurity among very-low-birth-weight infants in North Taiwan. Pediat Res. 2011;70:757. DOI: https://doi.org/10.1038/pr.2011.982

Darlow BA, Hutchinson JL, Henderson-Smart DJ, Donoghue DA, Simpson JM, Evans NJ. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand neonatal network. Pediatrics. 2005;115(4):990-6. DOI: https://doi.org/10.1542/peds.2004-1309

Downloads

Published

2026-02-21

How to Cite

Rahman, M. M., Adnan, M. A., Uddin, M. G., Haque, M. A., Ahmed, M., & Islam, M. T. (2026). Prevalence and risk factors of retinopathy of prematurity among preterm neonates admitted to a tertiary care hospital. International Journal of Contemporary Pediatrics, 13(3), 380–385. https://doi.org/10.18203/2349-3291.ijcp20260395

Issue

Section

Original Research Articles