The aim of this retrospective study was to determine factors significantly associated with ROP in ELBWs. 40 ELBWs were cared for in the Department of Neonatology 1, Kandang Kerbau Hospital, Singapore, between January 1993 and December 1994. The mean weight and gestation of these babies were 819±115g and 26.6±2.5 weeks respectively. 35 (87.5%) of these babies had Respiratory Distress Syndrome, 14 (35%) required surfactant, 40(100%) required intermitent positive pressure ventilation or continuous positive airway pressure. 14 (35%) had severe ROP (grade 3, 4 plus disease), 16 (40%) had mild ROP (grade 1, 2) and 10 (25%) had no ROP.

Babies with severe ROP were smaller (717.8±118.0g vs 831.1±122.1g, p=0.07), less mature (25.6±1.4 vs 27.7±3.2 weeks, p=0.02), required higher maximum airway pressure (10.2±2.5 vs 8.0±1.9 mmHg, p=0.02), higher respiratory rate (43.5±7.1 vs 33.9±10.4 per minute, p=0.04), higher peak inspiratory pressure(21.4±6.1 vs 17.6±4.0 mmHg, p=0.02) and higher FiO2(83.2±23.5 vs 61.0±29.3%, p=0.02). They were also more likely to develop bronchopulmonary dysplasia.

Thus, the prevention of ROP must be a multipronged approach where the least respiratory support sufficient for the babies' need is used. Great care should be taken in saturation oxygen monitoring to ensure that oxygen supplement is weaned down as soon as possible.