Risk factors and analysis of retinopathy of prematurity in monochorionic diamniotic twins

OBJECTIVES: To investigate the impact of intrauterine pathologies, including twin-to-twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR), on the development of retinopathy of prematurity (ROP) in monochorionic diamniotic (MCDA) twins and to establish risk prediction models. METHODS: A retrospective case-control study was conducted including 466 MCDA preterm twins born before 37 weeks. Participants were categorized into three groups (TTTS, sIUGR, and uncomplicated). Clinical and laboratory data were analyzed. Significant predictors were identified via random forest algorithm and multivariate logistic regression. ROC and DCA analyses were used to evaluate predictive models. RESULTS: ROP incidence was significantly higher in the TTTS group (37.8 %) compared with sIUGR (8.2 %) and uncomplicated twins (10.7 %) (p