Clinical analysis of risk factors for degree of retinal hemorrhages in healthy full-term newborns

Authors: Zhang Yanli,  Wang Xiaoyun,  Zhao Qi,  Lin Yu,  Liang Liqun

DOI: 10.3760/cma.j.issn.2095-0160.2017.07.014
Published 2017-07-10
Cite as Chin J Exp Ophthalmol, 2017,35(07): 640-644.

Abstract                              [Download PDF] [Read Full Text]


Retinal hemorrhage in newborns is a common clinical finding, and serious retinal henorrhage resulting in poor prognosis.The factors affecting retinal henorrhage in newborns are unelucidated now.Identifying these factors is helpful for the early prevention and treatment.


This study was to explore the underlying maternal, obstetric, and neonatal clinical factors for degree of retinal hemorrhages in healthy full-term newborns.


A cross-sectional study was performed in the approval of Ethic Committee of Zhongshan City People’s Hospital.A total of 1 311 full-term infants, with gestational age more than 37 weeks and Apgar ≥9 scores were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Ocular fundus of the infants were examined with Ret Cam Ⅲ within 4 days of birth and were independently identified by 2 eye doctors.The newborns of retinal hemorrhage were divided into grade Ⅰ, Ⅱ and Ⅲ groups based on Egge criteria, and the infants without retinal hemarrhage served as the normal control group.Maternal, obstetric, neonatal parameters and general factors were analyzed and compared among different groups, and the risk factors that affected the newborns retinal hemorrhage were analyzed by logistic regression analysis.


Retinal hemorrhage was seen in 28.30% infants (371/1 311), and 152, 116 and 103 infants were identified as gradeⅠ, Ⅱ and Ⅲ, with the percentage of 11.59%, 8.85% and 7.86%, respectively.Among the factors that examined in the study, cord around fetal neck was the risk factor of aggravation of degree of retinal hemorrhage in newborns(OR=1.308, 95%CI: 1.011-1.693, P=0.041). In the mode of delivery, spontaneous vaginal delivery appeared to be the positive factor of the incidence of retinal hemorrhage (OR=0.134, 95%CI: 0.132-0.137, P<0.001), but cesarean section was not a main risk factor.


Spontaneous vaginal delivery and cord around fetal neck are the potential risk factors for the aggravation of degree of retinal hemorrhage in full-term infants.Accordingly, infants with these risk factors should be paid more attention to prevent the progression of retinal hemorrhage.

Key words:

Newborns, full-term; Retina; Hemorrhage; Risk factors; Eye examination; Cross-sectional study

Contributor Information

Zhang Yanli
Department of Ophthalmology, Zhongshan City People’s Hospital, Zhongshan Hospital Affiliated to Sun Yat-Sen University, Zhongshan 528403, China
Wang Xiaoyun
Zhao Qi
Lin Yu
Liang Liqun
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