Abstract
BACKGROUND/OBJECTIVES: To examine how multiple birth status affects the incidence and severity of retinopathy of prematurity (ROP) in preterm infants. With increasing multiple births associated with assisted reproductive technology, this study seeks to clarify these risks independently of gestational age (GA) and birth weight (BW). SUBJECTS/METHODS: This retrospective observational study included 4392 preterm infants screened for ROP between 2010 and 2023. Eligibility criteria were GA ≤ 32 weeks, BW ≤ 2000 g, or unstable clinical conditions. ROP screening results, GA, BW, gender, and multiple birth status were analysed using multivariable logistic regression to assess predictors for ROP incidence and severity. RESULTS: Among the cohort, 1643 infants (37.4%) were from multiple births, and 780 infants (17.8%) were diagnosed with ROP. Multivariable analysis showed that lower GA (B: -0.063, OR = 0.94), lower BW (B: -0.001, OR = 0.999), and multiple birth status (B: 0.41, OR = 1.51) were independently associated with ROP incidence. For ROP severity, only lower BW (beta: -0.17, B: -0.01) and multiple birth status (beta: 0.08, B: 2.69) were significant. CONCLUSIONS: Multiple birth status may be independently associated with an increased risk and severity of ROP in preterm infants. These findings warrant further investigation to validate the association and to explore whether infants from multiple gestations might benefit from more tailored screening strategies.