Iranian Journal of Neonatology

Iranian Journal of Neonatology

Retinopathy of Prematurity: Correlating Neonatal Risk Factors with Disease Severity in a Tertiary Referral Center in Shiraz, Iran

Document Type : Original Article

Authors
Mahsa Rouhafshari 1
Hamide Barzegar 2
Zahra Hashemi 2
Roya Oboodi 2
Mahdi Khazaei 3
Fateme Ziyaee 1
1 Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
2 Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3 Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
10.22038/ijn.2026.85247.2636
Abstract
Background: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. This study evaluated the risk factors for ROP in preterm and at-risk neonates.
Methods: This descriptive, analytical, cross-sectional study was conducted at Namazi and Hafez hospitals from April 2020 to March 2021. A sample size of 183 neonates was calculated based on previous studies. Data on demographic and clinical factors, including gestational age, birth weight, sepsis, respiratory support, packed cell transfusion, hypotension, Apgar score, and hypoglycemia, were collected from hospital records. Statistical analyses were performed using SPSS, employing chi-square and logistic regression tests, with a significance level set at P < 0.05.
Results: The mean birth weight was 1444.9 ± 335.59 grams, and the mean gestational age was 31.01 ± 2.36 weeks. Lower gestational age and birth weight were significantly associated with ROP (P < 0.001). Among infants with a gestational age of less than 34 weeks, ROP severity was significantly associated with blood transfusion (P < 0.001), sepsis (P = 0.003 for zone, P = 0.03 for stage), and severe hypoglycemia (P < 0.001 for zone, P = 0.03 for stage). In infants born at or after 34 weeks, blood transfusion was the primary factor associated with ROP severity (P = 0.018 for zone).
Conclusion: Our study identified lower gestational age, birth weight, blood transfusion, sepsis, and hypoglycemia as significant risk factors for ROP severity in neonates under 34 weeks of gestation. The findings underscore the importance of vigilant monitoring and management of these risk factors to prevent the progression of ROP.
 
Keywords
Blood transfusion
Premature birth
Retinopathy of prematurity
Sepsis
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Iranian Journal of Neonatology
Volume 17, Issue 2
Spring 2026
Pages 13-20