Researchers recently developed a sex-specific clinical prediction model to improve retinopathy of prematurity screening for vulnerable infants. This innovative tool identifies infants at high risk for treatment-required retinopathy of prematurity (TR-ROP) based on biological sex. Although birth weight and gestational age remain primary predictors, the study highlights unique independent factors for each sex. Identifying these nuances ensures that clinicians can tailor monitoring to the specific biological needs of each neonate.

Optimizing Retinopathy of Prematurity Screening

For example, multiple births and hypoxic-ischemic encephalopathy significantly impact risk in male infants. Conversely, head circumference and cesarean delivery act as specific risk indicators for female preterm neonates. Furthermore, the logistic regression models demonstrated exceptional performance in internal validation cohorts. The results showed high sensitivity and specificity, reaching an AUC of up to 0.995 for female subjects. These findings emphasize that a one-size-fits-all approach may overlook critical sex-based vulnerabilities.

Consequently, utilizing these models could reduce the burden of unnecessary fundus examinations in neonatal intensive care units. In addition, external validation confirms the generalizability of these tools across different clinical settings. Therefore, integrating these sex-stratified assessments may enhance precision in identifying high-risk profiles early. Ultimately, such advancements provide a clear path toward personalized medicine in neonatal eye care and help prevent severe visual impairment.

What are the unique risk factors for TR-ROP in male infants?

In male preterm infants, key risk factors include birth weight, gestational age, hypoxic-ischemic encephalopathy, multiple births, and a history of blood transfusions. Understanding these specific triggers allows for more aggressive monitoring of at-risk male neonates.

How do sex-specific models improve clinical outcomes?

These models improve outcomes by accurately identifying high-risk profiles for treatment-required disease. This precision helps clinicians reduce unnecessary fundus examinations while providing targeted guidance to prevent disease progression in those who truly need it.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Xu Y et al. Development and validation of sex-specific clinical prediction models for treatment-required retinopathy of prematurity. Retina. 2026 May 06. doi: 10.1097/IAE.0000000000004878. PMID: 42090189.

Balakrishnan U et al. Screening based on incidence of severe retinopathy of prematurity in a tertiary care center in India: are Indian infants different? Int J Contemp Pediatr. 2016;3(4):1253-1258. doi: 10.18203/2349-3291.ijcp20162263.