Which of the following is the most important risk factor for retinopathy of prematurity (ROP)?

The most important risk factor for retinopathy of prematurity (ROP) is immaturity or prematurity. ROP primarily affects infants who are born prematurely, particularly those born before 28 weeks of gestation or those with a very low birth weight. The retinas of these infants are not fully developed at birth, making them more susceptible to the pathological changes associated with ROP. As the infant grows and develops, the risk of ROP is influenced by factors such as fluctuations in oxygen levels, but the underlying issue is the immaturity of the vascular and retinal development at the time of birth.

While low birth weight can be a contributing factor to ROP, it is generally considered a consequence of prematurity. Maternal smoking and oxygen exposure also play roles in the development of ROP; however, they are not as critical as the factor of immaturity itself. The significant relationship between gestational age at birth and the likelihood of developing ROP underscores the importance of prematurity in this condition. Thus, recognizing immaturity/prematurity as the primary risk factor allows healthcare providers to implement appropriate monitoring and preventative measures in at-risk neonates.