Factors related to retinal haemorrhage in infants born at high risk

Purpose: This study aims to determine risk factors for retinal haemorrhage (RH) in high-risk infants.

Methods: A total of 3123 cases with high-risk pregnancy and/or neonatal asphyxia 72 hr after delivery were enrolled into this study. Fundus examinations were performed on newborns utilizing a wide-angle imaging system (RetCam III). Retinal haemorrhage (RH) was classified into three grades. Maternal, obstetric and neonatal parameters from high-risk infants with RH were compared with parameters from infants without RH.

Results: Retinal haemorrhage (RH) was found in 550 (18%) of 3123 high-risk infants. Retinal haemorrhage (RH) was classified as grade I (39%), grade II (24%) and grade III (37%). Monocular RH occurred in 37% of cases, while the remaining cases were binocular. Moreover, six cases had vitreous haemorrhage. The following parameters correlated (p < 0.05) with RH in this study: delivery mode (χ² = 469), gestational age (χ² = 35), birth weight (χ² = 18), asphyxia (χ² = 73), scalp hematoma (χ² = 55), maternal age (χ² = 8.9), precipitate labour (χ² = 120) and delivery times (χ² = 6.1). Logistic regression analysis indicated that delivery mode and asphyxia were risk factors for RH in high-risk infants, with odds ratios of 0.827 and 2.5, respectively. Gender, intracranial haemorrhage and foetal distress were not correlated with RH in high-risk infants.

Conclusion: The incidence of RH in high-risk infants was 18%, and delivery mode, and neonatal asphyxia were major risk factors for RH in high-risk infants.