Retinopathy of prematurity: Incidence throughout a 15-year period in the NEOCOSUR Neonatal Network

Determine ROP overall incidence trends, stratified by gestational age (GA), throughout a 15-year period in the neonatal NEOCOSUR Network. Also, determine the main associated factors.

Retrospective cohort study, employing prospectively collected data. Trends were analyzed with joinpoint regression. Multivariable logistic regression was performed to identify factors associated with ROP after adjusting for key perinatal confounders.

VLBW infants between 24 and 31 weeks GA and BW 400 to 1500 g who survived to discharge, born between 2007 and 2021, across 21 centers were included.

Trends in ROP incidence throughout a 15-year period in this Network and main associated factors.

10,268 preterm infants were included. Baseline population differences with and without ROP were found. ROP incidence was higher in infants with lower gestational age. There was a significant decreasing trend in ROP incidence between 2007 and 2012 (30% to 18%); however, from 2012 to 2021, an increased incidence was observed, reaching 27% in 2021, although this change was not statistically significant. Moreover, a significant increasing trend occurred in severe ROP and/or plus disease in the 2013-2021 period. Female sex was protective for ROP (OR 0.84), whereas postnatal steroids nearly doubled the odds (OR 1.85). Each additional week of GA (OR 0.78) and every additional 100 g of BW (OR 0.79) were associated with lower odds of ROP. Cesarean section (OR 0.87) and every additional 100 g of weight gain at 28 days (OR 0.84) were also associated with reduced odds of ROP.

ROP showed an initial decreasing trend followed by an increased incidence in more recent years. Possible causes for these variations are uncertain.