Analysis of risk factors for retinopathy of prematurity: a single-center retrospective cohort study.

Background: Retinopathy of prematurity (ROP) remains a significant cause of preventable childhood blindness worldwide. This study aimed to analyze perinatal and postnatal risk factors associated with ROP development in premature infants, with particular focus on potentially modifiable factors. Methods: This retrospective cohort study included 346 preterm infants who underwent ROP screening. Comprehensive data collection included demographic characteristics, maternal factors, clinical interventions, respiratory support parameters, and metabolic disorders. Variables with P<0.05 in bivariate analysis were included in multivariate logistic regression. Results: Among 346 preterm infants, 17 (4.91%) developed ROP. Multivariate analysis identified several significant independent risk factors for ROP development. Duration of non-invasive ventilation showed increased risk [odds ratio (OR) =1.49; 95% confidence interval (CI): 1.2-1.8; P=0.002], as did hypophosphatemia (OR =2.29; 95% CI: 1.2-3.5; P<0.001). Prolonged hospital stay (OR =1.35; 95% CI: 1.2-1.5; P=0.005) and apnea (OR =2.01; 95% CI: 1.2-2.1; P=0.03) were also significant risk factors. The ROP group demonstrated significantly higher rates of bronchopulmonary dysplasia (64.71% vs. 21.88%; P<0.001) and required longer time to achieve full enteral feeding (35.0±17.10 vs. 24.64±15.17 days; P=0.006). Conclusions: This study identified novel associations between metabolic derangements (particularly hypophosphatemia) and ROP development. The findings suggest that optimizing metabolic parameters, respiratory support, and nutritional management may offer new opportunities for ROP prevention.