Which statement about risk factors for retinopathy of prematurity is true?

Which statement about risk factors for retinopathy of prematurity is true?

• A. Risk is negligible after 60 weeks postconceptual age
• B. Risk is inversely related to birth weight
• C. Risk is higher in full-term infants
• D. Risk is not related to oxygen exposure

Answer: (B)

Retinopathy of prematurity risk tracks with how premature the infant is. The more premature a baby (and the lower the birth weight), the more immature the retinal vessels are at birth, making them highly susceptible to abnormal vascular development in the NICU environment. Oxygen exposure plays a central role: high oxygen levels and fluctuations can blunt normal vessel growth in the developing retina and later hypoxia can drive abnormal neovascularization that can lead to vision-threatening disease. Because birth weight is a proxy for maturity, the risk rises as birth weight decreases, making the statement that risk is inversely related to birth weight the best choice. It’s not correct that risk becomes negligible after 60 weeks postconceptual age, since progression can occur or late disease can become apparent; it’s not correct that full-term infants have higher risk, as they typically have fully developed retinal vasculature and much lower risk; and it’s not correct to say oxygen exposure isn’t related, since oxygen management is a major, well-established risk factor.

Retinopathy of prematurity risk tracks with how premature the infant is. The more premature a baby (and the lower the birth weight), the more immature the retinal vessels are at birth, making them highly susceptible to abnormal vascular development in the NICU environment. Oxygen exposure plays a central role: high oxygen levels and fluctuations can blunt normal vessel growth in the developing retina and later hypoxia can drive abnormal neovascularization that can lead to vision-threatening disease. Because birth weight is a proxy for maturity, the risk rises as birth weight decreases, making the statement that risk is inversely related to birth weight the best choice.

It’s not correct that risk becomes negligible after 60 weeks postconceptual age, since progression can occur or late disease can become apparent; it’s not correct that full-term infants have higher risk, as they typically have fully developed retinal vasculature and much lower risk; and it’s not correct to say oxygen exposure isn’t related, since oxygen management is a major, well-established risk factor.