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Birth-related retinal hemorrhages in healthy full-term newborns and their relationship to maternal, obstetric, and neonatal risk factors

  • Pediatrics
  • Published:
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Abstract

Purpose

The purpose was to explore underlying maternal, obstetric, and neonatal risk factors of retinal hemorrhages (RH) in healthy full-term newborns.

Methods

A total of 1199 full-term infants, with gestational age more than 37 weeks and Apgar score of 7 or above, were included in this study. Infants with severe systemic diseases or any other eye diseases were excluded. Eye examinations with RetCamIII within 1 week of birth were performed in all infants. Maternal, obstetric, and neonatal parameters were analyzed and compared between newborns with RH and those without RH.

Results

RH was seen in 294 of the 1199 infants (24.5 %) in this study. Among factors examined in the study, spontaneous vaginal delivery (SVD) (odds ratio [OR] =3.811 [95 % CI2.649–5.483], P < 0.001) and cephalhematoma (OR = 1.823 [95 % CI1.009–3.296], P = 0.047) correlated positively with RH occurrence in newborns, while a history of cesarean delivery correlated negatively with RH occurrence (OR = 0.296 [95 % CI0.139–0.630], P = 0.002). There was no statistical correlation found between RH and the other risk factors examined in this study. These factors included gender, gestational age, birth weight, maternal age, volume, and turbidity of amniotic fluid, duration of the first or second stage of labor, anemia, hypertensive disorders complicating pregnancy (HDCP), fetal distress, intracranial hemorrhage, and neonatal hyperbilirubinemia.

Conclusions

RH is common in full-term newborns. A lower prevalence of newborn RH was found in infants delivered by mothers with a history of cesarean delivery. In contrast, SVD and cephalhematoma were found to be potential risk factors for the development of newborn RH in full-term infants. Infants with these risk factors may, therefore, require greater attention in regard to RH development.

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References

  1. Kaur B, Taylor D (1992) Fundus hemorrhages in infancy. Surv Ophthalmol 37(1):1–17

    Article  CAS  PubMed  Google Scholar 

  2. Emerson MV, Pieramici DJ, Stoessel KM, Berreen JP, Gariano RF (2001) Incidence and rate of disappearance of retinal hemorrhage in newborns. Ophthalmology 108(1):36–39

    Article  CAS  PubMed  Google Scholar 

  3. Watts P, Maguire S, Kwok T, Talabani B, Mann M, Wiener J, Lawson Z, Kemp A (2013) Newborn retinal hemorrhages: a systematic review. J AAPOS 17(1):70–78. doi:10.1016/j.jaapos.2012.07.012

    Article  PubMed  Google Scholar 

  4. Giles CL (1960) Retinal hemorrhages in the newborn. Am J Ophthalmol 49:1005–1011

    Article  CAS  PubMed  Google Scholar 

  5. Hughes LA, May K, Talbot JF, Parsons MA (2006) Incidence, distribution, and duration of birth-related retinal hemorrhages: a prospective study. J AAPOS 10(2):102–106

    Article  PubMed  Google Scholar 

  6. Chen LN, He XP, Huang LP (2012) A survey of high risk factors affecting retinopathy in full-term infants in China. Int J Ophthalmol 5(2):177–180. doi:10.3980/j.issn.2222-3959.2012.02.12

    PubMed Central  PubMed  Google Scholar 

  7. Li LH, Li N, Zhao JY, Fei P, Zhang GM, Mao JB, Rychwalski PJ (2013) Findings of perinatal ocular examination performed on 3573, healthy full-term newborns. Br J Ophthalmol 97(5):588–591. doi:10.1136/bjophthalmol-2012-302539

    Article  PubMed Central  PubMed  Google Scholar 

  8. Zhang J, Troendle J, Reddy UM et al (2010) Contemporary cesarean delivery practice in the United States. Am J Obstet Gynecol 203(4):326.e321–326.e310. doi:10.1016/j.ajog.2010.06.058

    Article  Google Scholar 

  9. Gibbons L, Belizan JM, Lauer JA, Betran AP, Merialdi M, Althabe F (2012) Inequities in the use of cesarean section deliveries in the world. Am J Obstet Gynecol 206(4):331.e1–19. doi:10.1016/j.ajog.2012.02.026

    Article  Google Scholar 

  10. Zhang J, Liu Y, Meikle S, Zheng J, Sun W, Li Z (2008) Cesarean delivery on maternal request in southeast china. Obstet Gynecol 111(5):1077–1082. doi:10.1097/AOG.0b013e31816e349e

    Article  PubMed  Google Scholar 

Download references

Funding

This study was supported by the Zhongshan City Science and Technology Planning Project (No.20122A003) and the National Natural Science Foundation of China (No.81341028).

Contribution statement

Dr. Qi Zhao and Dr. Yanli Zhang contributed equally to this work and share the first authorship.

The various contributors and their contributions were: design and conduct of study (Q.Z., Y.Z., X.D.); collection of data (Y.Z., Y.Y., Z.L., Y.L., C.W.); management, analysis, and interpretation of data (Y.Y., R.L.); preparation of the manuscript (X.D., Y.Y.); and review and approval of manuscript (X.D., Y.Y.).

Conflict of interest disclosures

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript.

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    Authors and Affiliations

    1. Department of Ophthalmology, Zhongshan People’s Hospital, Zhongshan Hospital, Sun Yat-San University, 2 Sunwen East Road, 528403, Zhongshan, China

      Qi Zhao, Yanli Zhang & Yu Lin

    2. Southern Medical University, 1023 Shatai S Road, 510515, Guangzhou, China

      Yanli Zhang

    3. Guangdong General Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, China

      Yanli Zhang

    4. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-San University, 54 Xianlie S Road, 510060, Guangzhou, China

      Yu Yang, Zijing Li, Ran Liu, Chunyi Wei & Xiaoyan Ding

    Authors
    1. Qi Zhao
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    2. Yanli Zhang
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    3. Yu Yang
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    4. Zijing Li
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    5. Yu Lin
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    6. Ran Liu
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    8. Xiaoyan Ding
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    Corresponding author

    Correspondence to Xiaoyan Ding.

    Additional information

    Qi Zhao and Yanli Zhang contributed equally to this work.

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    Zhao, Q., Zhang, Y., Yang, Y. et al. Birth-related retinal hemorrhages in healthy full-term newborns and their relationship to maternal, obstetric, and neonatal risk factors. Graefes Arch Clin Exp Ophthalmol 253, 1021–1025 (2015). https://doi.org/10.1007/s00417-015-3052-9

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    • DOI: https://doi.org/10.1007/s00417-015-3052-9

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