Incidence and rate of disappearance of retinal hemorrhage in newborns

Objective: To determine the prevalance, associated biometric factors, and r ate of disappearance of neonatal retinal hemorrhage. Design: Cross-sectional and natural history study. Methods: Healthy newborns (n = 149) at an urban hospital were examined usin g indirect ophthalmoscopy within 30 hours of birth. Newborns with retinal h emorrhage were reexamined biweekly until hemorrhage resolved. Main Outcome Measures: Neonatal and maternal biometric factors, and inciden ce 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 f or 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 birt h, retinal hemorrhage resolved in 86% of eyes, and at 4 weeks no intraretin al hemorrhage was detected, although a single subretinal hemorrhage persist ed 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 wi th factors other than birth. Ophthalmology 2001;108:36-39 (C) 2001 by the A merican Academy of Ophthalmology.