Retinopathy of prematurity in infants with a gestational age <27 weeks in Saint Petersburg: a comparative analysis of 2014 and 2023 data

BACKGROUND: According to the Federal State Statistics Service, birth rates in Saint Petersburg have decreased by 17.6% over the past five years. At the same time, the rates of preterm birth and infant mortality remain consistently low, ranging from 5.5% to 5.8% and from 4.1‰ to 3.1‰, respectively, whereas survival of extremely preterm infants continues to increase. Under these conditions, the priority becomes not only preserving the life of each child, but also ensuring its quality, particularly through the prevention of visual impairment. Retinopathy of prematurity remains the leading cause of childhood blindness and visual disability both in the Russian Federation and in Saint Petersburg.

AIM: To evaluate temporal trends in the frequency, severity, and treatment effectiveness of active retinopathy of prematurity in infants with a gestational age ≤26 weeks in Saint Petersburg by comparing data from 2014 and 2023.

METHODS: A single-center, retrospective, cross-sectional study (medical record review) was conducted. The study included data from extremely preterm infants who received treatment and neonatal care at the Children’s City Multidisciplinary Clinical Specialized Center for High Medical Technologies in 2014 and 2023. Trends in the frequency, severity, and treatment effectiveness of active retinopathy of prematurity in infants with a gestational age ≤26 weeks in Saint Petersburg were assessed by comparing data from 2014 and 2023.

RESULTS: The final sample included data from 162 infants with a gestational age ≤26 weeks who were followed from the first days of life until discharge: in 2014 (n = 87) and in 2023 (n = 75). The frequency of retinopathy of prematurity increased by 7% in 2023, accompanied by a 6% decrease in early stages (stages 1–2), which are typically characterized by spontaneous regression. Substantial differences were also observed in the frequency of progression to severe forms requiring treatment—from 32% of infants (one in three) in 2014 to 42.7% (nearly one in two) in 2023. A statistically significantly higher rate of posterior aggressive retinopathy of prematurity in 2023 compared with 2014 was associated with a 5.8-fold increase in unfavorable outcomes, characterized by retinal detachment and loss of visual function.

CONCLUSION: Comparative analysis of active retinopathy of prematurity in infants with a gestational age <27 weeks in 2014 and 2023 demonstrated an increased frequency of severe disease forms and visual impairment, despite unified treatment protocols and earlier retinal laser photocoagulation in 2023.