Is Neonatal Anemia a Risk Factor in Developing Retinopathy of Prematurity in Premature Babies: A Prospective Observational Study in Rural North India

Dr. Monika Verma, Dr. Aabhas Bhansali, Dr. Vaishnavi Singh

Abstract: Background: Retinopathy of prematurity (ROP) is a vision-threatening vasoproliferative disorder that predominantly affects premature infants and is a leading cause of avoidable childhood blindness worldwide. While low gestational age and birth weight are established risk factors, recent evidence suggests that neonatal anemia may independently contribute to ROP development through exacerbation of retinal hypoxia and altered angiogenic signaling. Aim: To determine the incidence of ROP in premature infants admitted to a rural Sick Newborn Care Unit (SNCU) in North India and evaluate whether neonatal anemia acts as a significant risk factor for ROP. Materials and Methods: A prospective observational study was conducted over one year (November 2023?October 2024) including 120 preterm infants with gestational age <34 weeks or birth weight <2000 g. Detailed clinical records including anemia status, blood transfusion history, and neonatal comorbidities were collected. ROP screening was performed by indirect ophthalmoscopy and classified according to ICROP guidelines. Statistical analysis was done using Chi-square test, with p < 0.05 considered significant. Results: ROP occurred in 32 of 120 infants (26.7%), with Stage 2 being the most common presentation (43.7%). Of the 32 affected infants, 10 (31.3%) required treatment while 22 (68.7%) showed spontaneous regression. Anemia was present in 30 infants; 14 (46.7%) developed ROP compared with 18 of 90 (20.0%) non-anemic infants (p = 0.004). ROP occurred in 56.2% of transfused infants versus 22.1% in non-transfused infants (p = 0.01). Conclusion: Neonatal anemia significantly increases the risk of ROP, and blood transfusion further compounds disease severity. Early detection and correction of anemia, alongside restrictive transfusion practices and structured screening, may reduce severe ROP burden in rural preterm populations.

Keywords: Retinopathy of prematurity, neonatal anemia, prematurity, blood transfusion, VEGF, blindness prevention

How to Cite?: Dr. Monika Verma, Dr. Aabhas Bhansali, Dr. Vaishnavi Singh, "Is Neonatal Anemia a Risk Factor in Developing Retinopathy of Prematurity in Premature Babies: A Prospective Observational Study in Rural North India", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 1528-1528, https://www.ijsr.net/getabstract.php?paperid=MR251121145434, DOI: https://dx.doi.org/10.21275/MR251121145434