Retinal and intraventricular cerebral hemorrhages in the preterm infant born at or before 30 weeks' gestation

Purpose: To determine the prevalence of retinal hemorrhages and their assoc iation with cerebral intraventricular hemorrhages (IVH) in low-birth-weigh: preterm neonates born at or before 32 weeks' gestation. Methods:We prospec tively studied a consecutive series of 22 neonates (24-30 weeks' gestation; mean gestational age, 27 weeks; mean weight, 1065 g) admitted to the neona tal intensive care unit. Anterior segment and indirect ophthalmoscopic exam ination, as well as cranial ultrasonographic examination, were performed on day 1 and day 10 of life. The prevalence of retinal and intraventricular h emorrhage was tested statistically for association with obstetric and neona tal clinical variables. Results: The prevalence of retinal hemorrhage was 9 % (2/22; 95% CI, 3%-21%) on day 1 and 2% (1/22) on day 10. The prevalence o f IVH was 27% (6/22; 95% CI, 9%-46%). 14% (3/22) on day 1 and 23% (5/22) on day 10. Retinal hemorrhages occurred with greater frequency in neonates bo rn to women who had intrauterine infection (chorioamnionitis, P=.043) anti low umbilical cord pH levels(P=.027). No association was found between the presence of retinal hemorrhage and IVH (P=1.000), mode of delivery tie, vag inal vs cesarean section, P=1.000), birth weight (P=.476), or gestational a ge (P=1.000). The presence of subconjunctival hemorrhage was associated wit h IVH (P=.046). Conclusions: Retinal hemorrhages occur in less than 10% of low-birth-weight neonates, ie, a prevalence one half that observed in term neonates (22%). The hemorrhages tend to resolve without sequelae in the fir st 10 days of life and occur more commonly in infants born to women with ut erine infection. Retinal hemorrhages in very premature neonates are not pre dictive of IVH-related brain damage.