Development of a scoring model integrating inflammatory markers for predicting ROP in preterm neonates

ROP is a leading cause of blindness in preterm infants worldwide. ROP diagnosis is made through a detailed eye examination and supportive methods are required, especially in limited centers. ROP diagnosis primarily relies on frequent ophthalmological examinations; however, complementary diagnostic tools may significantly aid clinicians, particularly in centers with limited resources. This study introduces an innovative scoring model integrating systemic inflammatory markers for its early prediction of ROP.

A retrospective case-control study involving 120 preterm infants (≤ 32 weeks, ≤ 1500 g) was conducted. Hemogram-based inflammatory indices, including the Systemic Inflammatory Response Index (SIRI), Platelet-to- Lymphocyte Ratio (PLR), and Pan-Immun Inflammatory Value (PIV), were calculated from blood samples obtained within the first 24 h of life and before ROP diagnosis. Logistic regression and ROC analyses informed the scoring model.

Infants with ROP showed lower gestational ages and birth weights (p < 0.001, p = 0.02). SIRI-2 displayed the highest diagnostic accuracy (AUC = 0.704). A combined model using SIRI-2, PLR-2, and PIV-2 achieved superior performance (AUC = 0.802). Logistic regression identified SIRI-2 and PLR-2 as independent predictors, enhancing risk stratification.

This scoring model not only enhances early risk stratification but also holds potential for widespread implementation in neonatal intensive care units, particularly in resource-limited settings. Future multicenter trials will further establish its role in optimizing neonatal outcomes globally.