Incidence and rate of disappearance of retinal hemorrhage in newborns

Abstract

Objective: To determine the prevalance, associated biometric factors, and rate of disappearance of neonatal retinal hemorrhage.

Design: Cross-sectional and natural history study.

Methods: Healthy newborns (n = 149) at an urban hospital were examined using indirect ophthalmoscopy within 30 hours of birth. Newborns with retinal hemorrhage were reexamined biweekly until hemorrhage resolved.

Main outcome measures: Neonatal and maternal biometric factors, and incidence and rate of resolution of retinal hemorrhage.

Results: Intraretinal hemorrhage was present in 34% of newborns and varied from a single dot hemorrhage in one eye to bilateral widespread hemorrhages, occasionally with white centers. The incidence of hemorrhage was higher for vacuum-assisted (75%) than for spontaneous vaginal deliveries (33%) and was least for infants delivered by cesarean section (7%). The mean maternal age was greater for infants with retinal hemorrhage. By 2 weeks after birth, retinal hemorrhage resolved in 86% of eyes, and at 4 weeks no intraretinal hemorrhage was detected, although a single subretinal hemorrhage persisted until 6 weeks after birth.

Conclusions: Intraretinal hemorrhages are common in the immediate postnatal period and resolve by 1 month of age. Retinal hemorrhage in infants older than 1 month should heighten suspicion that the hemorrhage is associated with factors other than birth.