Preterm babies are at risk for delayed retinal maturation including retinopathy of prematurity. This study intends to analyse the prevalence of delay in retinal maturation among preterm infants, in a tertiary care institution in north Kerala. The factors affecting retinal maturation are evaluated. Methodology: Design- descriptive cross sectional; duration 6 months; inclusion - preterm infants with birth weight less than or equal to 1.5 kg and gestational age less than or equal to 32 weeks; sample size - 76; variables-maternal risk factors, age at birth, gender, birth weight, weight at 38 weeks and fetal risk factors. Results: Male female ratio was 2.1:1.7, 51.3% had adequate retinal maturation, 23.7% had delayed retinal maturation and 25% had progressed to ROP. The mean birth weight was 1.22 kg (SD 0.223). The mean gestational age was 30.29days.The mean weight at 38 weeks was 1.801 kg. Maternal factors did not affect the outcome. Delay in retinal maturation and ROP were associated with lower gestational age (p 0.01), birthweight (p 0.09), male gender(p 0.04), mechanical ventilation (p 0.016), surfactant use ( p 0.003), anemia of prematurity (p 0.09), blood transfusion (p 0.016), sepsis (p 0.091) and NEC ( p0.026). Use of antenatal steroids (p 0.09), adequate gain in weight ( p 0.113) and breastfeeding soon after birth( p 0.027) had a positive association with maturation. Conclusion: Gestational age at birth, birth weight , male gender , hypoxia & need for assistive devices, nutritional factors, hemodynamic factors, CHD, PDA, use of surfactants , sepsis and NEC were associated with poor retinal maturation. Use of antenatal steroids, adequate gain in weight and breastfeeding soon after birth were protective.

Keywords : retinopathy of prematurity, delayed retinal maturation, preterm, fetal hypoxia, early breast feeding.