Perinatal Risk Factors for the Retinopathy of Prematurity in Postnatal Growth and Rop Study

<b>Objective</b>: To evaluate perinatal risk factors for retinopathy of prematurity (ROP), in a large, broad-risk cohort of premature infants. <b>Study design</b>: Secondary analysis of data from the Postnatal Growth and ROP (G-ROP) Study, a retrospective cohort study of infants undergoing ROP examinations at 29 North American hospitals in 2006–2012. <b>Results</b>: Among 7483 infants, 3224 (43.1%) had any ROP and 931 (12.4%) had severe ROP (Type 1 or 2 ROP). In multivariable logistic regression analysis, significant risk factors for any ROP were lower birth weight (BW, odds ratio (OR) = 5.2, &lt;501 g vs. &gt;1250 g), younger gestational age (GA, OR = 32, &lt;25 vs. &gt;29 weeks), 1-min Apgar score &lt;4 (OR = 1.2), race (OR = 1.6, White vs. Black), outborn (OR = 1.5), and delivery room intubation (OR = 1.3); and for severe ROP were lower BW (OR = 20, &lt;501 g vs. &gt;1250 g), younger GA (OR = 30, &lt;25 vs. &gt;29 weeks), male (OR = 1.5), Hispanic ethnicity (OR = 1.8), race (OR = 1.6, White vs. Black), outborn (OR = 1.6), and delivery room intubation (OR = 1.6). Together, these factors predicted well for any ROP (area under ROC curve (AUC) = 0.87) and severe ROP (AUC = 0.89), but BW and GA were the dominant factors for ROP (AUC = 0.86) and severe ROP (AUC = 0.88). <b>Conclusions</b>: Based on the largest report to date with detailed ROP data from infants meeting current screening guidelines, ROP risk is predominantly determined by the degree of prematurity at birth, with other perinatal factors contributing minimally.