Development and validation of a multivariate nomogram for predicting retinopathy of prematurity in infants with gestational age ≤34 weeks.

PURPOSE

To delineate risk factors and develop a predictive nomogram for retinopathy of prematurity (ROP) in infants with gestational age (GA) ≤34 weeks.

METHODS

We conducted a comprehensive retrospective analysis of infants with GA ≤34 weeks, divided into ROP and non-ROP groups based on fundus screening results. Clinical and laboratory data were collected to identify risk factors associated with ROP. Multivariable logistic regression was performed to identify independent predictors, and a nomogram was developed to predict the occurrence of ROP in infants with GA ≤34 weeks.

RESULTS

Our analysis identified five independent risk factors for ROP in infants with GA ≤34 weeks: hypertensive disorders of pregnancy (HDP), number of blood transfusions, oxygen therapy time (OTT), oxygen therapy concentration (OTC) >50%, and blood glucose spikes in the first postnatal week. These predictors were incorporated into a nomogram to estimate individual ROP risk. The predictive model achieved a C-index of 0.923 (95% CI: 0.888-0.959), indicating high predictive accuracy. Internal validation of the nomogram demonstrated excellent calibration and practical utility for clinical decision-making.

CONCLUSIONS

The established predictive model, incorporating five key clinical parameters, offers clinicians a practical instrument to stratify ROP risk in neonates born at ≤34 weeks' gestation. This clinical tool demonstrates significant utility in guiding intervention protocols, potentially enhancing patient outcomes through early identification and optimized management strategies.

REGISTRATION NUMBER

ChiCTR2400086213.