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

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.