P1.183: Retinopathy of Prematurity and its relationship with Postnatal Weight gain in Premature infants and IUGR infants - Retrospective cohort Study.

Background: Retinopathy of prematurity (ROP) is a disease of aberrant vascularization of the retina that has potentially devastating effects on vision in preterm infants and can lead to blindness. The incidence of ROP showed an increasing trend due to higher survival rates for extremely preterm infants over the last two decades. ROP is a multifactorial disease. Low gestational age, Low birthweight, oxygen therapy, and several well-known morbidities of prematurity, such as necrotizing enterocolitis (NEC), sepsis, and Intraventricular hemorrhage, are shown to be associated with ROP. Recent data suggest that poor weight gain during the first weeks of life is one of the strongest positive predictors of ROP. Few studies have shown that adequate postnatal weight gain can be a protective factor from developing ROP. We aim to study the effect of adequate post-natal weight gain and its impact on the incidence and severity of ROP in preterm infants and IUGR infants.

Methods: Observational, Retrospective cohort study. We reviewed the charts of Premature infants (22 weeks- 31 weeks), IUGR infants who had ROP screening as per protocol from April 2023- April 2024 in the level 4 NICU. Exclusion criteria include infants with congenital anomalies and infants who transferred out or lost follow-up for the ROP exam. A total of 195 charts were reviewed, and 166 infants were included in the study. Statistical Analysis: Mann-Whitney U test, independent samples t-test, Pearson’s chi-square, Fisher’s exact test.

Results: Severe ROP includes ROP stage 3 or more with or without plus disease. The mean Birthweight for infants with severe ROP was 627 grams, whereas for non-severe ROP, it was 1081 grams. The mean gestational age for infants with severe ROP is 25 weeks, whereas for non-severe ROP it is 28+2 weeks. Optimal Weekly weight gain is 105-175 grams/kg/week (15-25g/kg/day). Out of 166, 153(92%) infants were in a non-severe group and 13(8%) were in a severe group. 100% of infants in the Severe ROP group had sub-optimal weight gain( < 105g/kg/week). Whereas, 47.7% of infants in the non-severe ROP group had suboptimal weight gain with a P value of < 0.01. All the infants who underwent treatment for ROP (either Laser or Avastin treatment) had suboptimal weight gain. 44 infants were IUGR out of 166 infants. 100% of IUGR infants with suboptimal weight gain developed Severe ROP In contrast, 0% of IUGR infants with optimal weight gain developed Severe ROP, with a P value of < 0.01.

Conclusion: In Conclusion, we have hypothesized that optimal postnatal weight gain is a protective factor for ROP in premature infants and IUGR infants. Nutrition needs more attention in infants at risk during the NICU course. Further investigations are warranted to strengthen this association with a prospective study.