P1.186: A Study on Association Between Maternal Risk Factors and Treatment-Required Retinopathy of Prematurity

Background: India is facing an ROP epidemic due to improved neonatal survival, yet screening remains insufficient, and advanced cases are often detected too late. Timely treatment is crucial to prevent vision loss in these cases. While much research focuses on perinatal and neonatal risk factors, maternal factors have received limited attention.

Objective: To assess the association between ROP requiring treatment and maternal risk factors, including maternal age, PIH, antenatal steroid use, antepartum hemorrhage, mode of delivery, anemia, gestational diabetes, premature rupture of membranes, chorioamnionitis, gestation type (single/multiple), and Doppler abnormalities during pregnancy.

Methods: This observational cohort study was conducted over 9 months in a level III NICU at a tertiary care center. It included live-born infants with a gestational age < 35 weeks. Data relevant to the study objectives were collected from retrospective chart review. ROP was classified and treated according to standard guidelines. The sample size was calculated using the formula for 1 proportion. Data analysis was performed using Chi-square or Fischer’s exact test for qualitative variables and Student’s t-test for parametric numerical variables.

Results: A total of 288 infants were enrolled in the study. Of these, 127 infants (44.09%) developed ROP, and 43 infants (14.93%) had stages of ROP that required treatment. Among all ROP cases, 33.85% required treatment. Out of all studied maternal risk factors, Univariate analysis identified Doppler abnormalities, maternal anemia, and premature rupture of membranes lasting >24 hours as statistically significant. However, multivariate regression analysis showed that maternal anemia, the need for resuscitation at birth, mechanical ventilation, and SGA status were associated with treatment-requiring ROP. 24 out of 43 which is 55.81% of infants who required treatment for ROP had anemic mothers.

Conclusion: In our study, maternal anemia was strongly associated with treatment-requiring stages of ROP. Similar to other studies, perinatal risk factors such as the need for resuscitation at birth, mechanical ventilation, and SGA status were also linked to treatment requiring ROP. While much focus has been placed on minimizing perinatal risk factors, larger-scale studies are needed to explore the connection between maternal anemia and treatment-requiring ROP, especially in developing countries with high maternal anemia prevalence. Addressing maternal anemia could significantly reduce both maternal morbidity and the burden of ROP-related complications.