Surviving Extremely Low Birth Weight Infants Have a Higher Risk of ROP in Sub-Saharan Africa

Area of Science:

• Ophthalmology
• Neonatology
• Public Health

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
• Risk factors for ROP have been studied globally, but not in Sub-Saharan Africa (SSA).
• Improved neonatal care in SSA is increasing survival rates of at-risk preterm infants.

Purpose of the Study:

• To investigate the risk factors for ROP in a South African population.
• To address the lack of ROP studies in Sub-Saharan Africa.

Main Methods:

• Population-based study in Cape Town, South Africa (May 2022 - January 2023).
• Included infants with birth weight < 1250g or gestational age < 32 weeks.
• Data extracted from the Retinopathy of Prematurity South African register.

Main Results:

• 378 infants were screened; 115 (30.4%) developed ROP.
• Lower birth weight was an independent ROP risk factor (OR 1.3).
• Surgical necrotising enterocolitis (NEC) was another independent ROP risk factor (OR 5.8).
• Infants < 1000g were more likely to develop ROP (OR 2.4).

Conclusions:

• Birth weight remains a significant ROP risk factor, especially for infants < 1000g.
• These low birth weight infants constitute a substantial proportion of screened infants in this SSA region.
• Findings underscore the importance of ROP surveillance in preterm infants in SSA.