Predictive Value of Postnatal Weight Gain Rate for Severe Retinopathy of Prematurity in Preterm Infants: A Retrospective Analysis.

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.