Predicting the treatment-requiring retinopathy of prematurity using birth weight, laboratory data and continuous peripheral capillary oxygen saturation monitoring.

PURPOSE: This single-center retrospective study aimed to identify independent predictors of retinopathy of prematurity (ROP) treatment by integrating continuous pulse oximetry (SpO₂) data with comprehensive laboratory parameters.

STUDY

DESIGN

Single-center retrospective cohort study.

METHODS

We analyzed 244 neonates (gestational age < 34 weeks or birth weight < 1800 g) admitted between 2019 and 2023, excluding those with major genetic abnormalities. Logistic regression assessed associations between birth weight (BW), average SpO₂ at birth, hemoglobin (Hb), albumin (Alb), and selected inflammatory markers (e.g., neutrophil-to-lymphocyte ratio) with ROP treatment. Model discrimination was evaluated via receiver operating characteristic curves.

RESULTS

Of the 244 infants, 16.8% required treatment (laser therapy or anti-VEGF injections). Lower BW and lower Hb were significantly associated with treatment (P <0.05). In the final multivariable model, BW and Hb emerged as key predictors (AUC = 0.884; accuracy = 88%), while Alb and inflammatory indices were not independently significant. Predicted treatment probabilities decreased markedly as BW and Hb increased.

CONCLUSION

BW and Hb were primary predictors of ROP treatment necessity in this cohort, whereas Alb and inflammatory markers did not show independent associations. Incorporating continuous SpO₂ monitoring provided valuable respiratory insights. Further prospective, multicenter studies are warranted to validate these findings and refine ROP risk stratification strategies.