Development and Validation of a Multivariate Nomogram for Predicting Retinopathy of Prematurity in Infants with Gestational Age ≤ 34 Weeks

Abstract Purpose To delineate risk factors and develop a predictive nomogram for retinopathy of prematurity (ROP) in infants with gestational age (GA) ≤ 34 weeks. Methods We conducted a comprehensive retrospective analysis of infants with GA ≤ 34 weeks, divided into ROP and non-ROP groups based on fundus screening results. Clinical and laboratory data were collected to identify risk factors associated with ROP. Multivariable logistic regression was performed to identify independent predictors, and a nomogram was developed to predict the occurrence of ROP in infants with GA ≤ 34 weeks. Results Our analysis identified five independent risk factors for ROP in infants with GA ≤ 34 weeks: hypertensive disorders of pregnancy (HDP), number of blood transfusions, oxygen therapy time (OTT), oxygen therapy concentration (OTC) > 50%, and blood glucose spikes in the first postnatal week. These predictors were incorporated into a nomogram to estimate individual ROP risk. The predictive model achieved a C-index of 0.923 (95% CI: 0.888–0.959), indicating high predictive accuracy. Internal validation of the nomogram demonstrated excellent calibration and practical utility for clinical decision-making. Conclusions The validated nomogram, based on five critical factors, provides clinicians with a reliable tool for assessing the risk of developing ROP in infants with GA ≤ 34 weeks. This tool has the potential to improve outcomes by facilitating timely and appropriate therapeutic interventions.