Declining trends in retinopathy of prematurity screening eligibility among U.S. infants

A recent national study analyzed trends in retinopathy of prematurity (ROP) screening eligibility among U.S. infants from 2003 to 2022, revealing a significant decline in the number of infants meeting screening criteria. Using data from the Centers for Disease Control and Prevention’s WONDER database, researchers tracked birth weight and estimated gestational age as key eligibility factors based on Joint Statement Screening Guidelines.

The number of infants eligible for ROP screening peaked at 56,106 in 2007 but steadily declined to 41,083 by 2022, with an average of 47,088 eligible infants per year over the study period. The most notable drop occurred between the first and second 10-year periods, from an annual average of 50,895 to 43,281 infants. Birth weight slightly surpassed estimated gestational age as the leading determinant for screening eligibility.

State-level shifts also emerged, with Texas surpassing California in 2012 for the highest number of eligible infants, and Florida overtaking New York in 2011 for third place. Micropremature (24–26 weeks gestational age or birth weight 600–800 g) and nanopremature (<24 weeks gestational age or birth weight <600 g) infants followed the overall eligibility decline, with nanopremature infants experiencing a slightly greater relative decrease.

The findings align with a broader decline in U.S. birth rates and provide valuable insights into infant survivability and ROP screening trends.

Reference
Moshfeghi HP, Zaidi M, Kumm J, et al. The U.S.A. eligible retinopathy of prematurity screening population 2003-2022: WONDER-ROP Study. Early Hum Dev. 2025;201:106192. doi: 10.1016/j.earlhumdev.2025.106192. Epub 2025 Jan 4. PMID: 39842136.