Maternal Nutritional Status & Retinopathy of Prematurity

Background

Retinopathy of prematurity (ROP) is a leading cause of preventable childhood visual impairment, with the burden shifting increasingly toward low- and middle-income countries. While prematurity and supplemental oxygen are the most established risk factors, upstream antenatal determinants such as maternal nutritional status may also shape fetal retinal vascular development and neonatal outcomes. This study examines whether maternal anthropometry is associated with the key neonatal determinants of ROP risk in an Indian tertiary NICU setting, where maternal undernutrition and high preterm birth rates coexist.

Approach

This was a retrospective, descriptive-analytical study of 75 de-identified mother-infant pairs screened for ROP at a tertiary referral NICU. Maternal variables included weight, height, and BMI (categorised by WHO thresholds); neonatal variables included gestational age, birth weight, and ROP stage graded per the International Classification of ROP. Continuous variables were summarised as medians with IQR, and associations between maternal nutritional indicators and neonatal outcomes were assessed using Spearman’s rank correlation in R.

What we found

• Maternal BMI was positively correlated with neonatal birth weight (rho = 0.35, p = 0.018), and maternal weight more strongly so (rho = 0.42, p = 0.009).
• Lower maternal nutritional status was associated with earlier delivery (maternal BMI vs gestational age, rho = 0.31, p = 0.045); gestational age was the dominant determinant of birth weight (rho = 0.56, p < 0.001).
• The cohort was predominantly very preterm and very low birth weight (median gestational age 28 weeks, median birth weight ~1.1 kg) with median maternal BMI 20.3 kg/m², at the lower bound of normal.
• ROP staging was available for only 20 of 75 infants (27%); all staged cases were Stage 2, with no severe disease, so an independent association with ROP severity could not be demonstrated.

Outputs & impact

The study provides locally grounded Indian evidence linking maternal anthropometry to neonatal outcomes relevant to ROP risk and is best understood as hypothesis-generating, motivating adequately powered prospective work with complete maternal biochemical data and comprehensive ROP staging. A manuscript draft is ready for submission.