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J AAPOS. 2013 Feb;17(1):70-8. doi: 10.1016/j.jaapos.2012.07.012. Epub 2013 Jan 28.

Newborn retinal hemorrhages: a systematic review.

Author information

1
Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. patrickowatts@yahoo.co.uk

Erratum in

  • J AAPOS. 2013 Jun;17(3):341.

Abstract

PURPOSE:

To systematically review the characteristics, prevalence, evolution, and obstetric associations of retinal hemorrhages (RH) in newborns.

METHODS:

A systematic review, searching 10 databases (1970-2011), identified 45 studies, which underwent two independent reviews via the use of standardized critical appraisal. Studies meeting the following criteria were included: examination by an ophthalmologist, use indirect ophthalmoscopy, and first examination conducted within 96 hours of birth and before hospital discharge.

RESULTS:

Thirteen studies were included, representing 1,777 infants. The studies revealed that 25.6% of newborns born via spontaneous vaginal deliveries had RH. In contrast, infants delivered by vacuum extraction had a 42.6% rate of RH (OR, 2.75; 95% CI, 1.32-5.70), and infants delivered by double-instrument deliveries (forceps and vacuum) had a 52% rate of RH (OR, 3.27; 95% CI, 1.68-6.36). The hemorrhages are commonly bilateral (59%), of varying severity, from "mild" (22%-56%) to "severe" (18%-37%), and predominantly intraretinal and in the posterior pole. The majority of RH (83%) resolved within 10 days; isolated cases persisted to 58 days.

CONCLUSIONS:

Birth-related RH in infants occurs in one-quarter of normal deliveries and are far more common after instrumental deliveries. Commonly bilateral, they were predominantly intraretinal, posterior, resolved rapidly, and very rarely persisted beyond 6 weeks.

PMID:
23363882
DOI:
10.1016/j.jaapos.2012.07.012
[Indexed for MEDLINE]

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