Related Factors Of High-risk Newborn Retinal Hemorrhage

Purpose:To study the cause of high-risk neonatal retinal hemorrhage risk and analyze its related factors.Methods:After the first72hours of the birth, the newborns in the pediatrics,which suffered from premature encephalopathy or neonatal jaundice or intracranial hemorrhage or neonatal infection and so on, were examined for fundus used the wide area digital fundus imaging system (RetCam Ⅱ). We observed morphology and characteristics of neonatal retinal hemorrhage, and retrospective investigated the newborns’ delivery mode, gestational age, birth weight, gender, conditions of birth, wheather there mother had some disease and so on, and then to find the cause of the newborn retinal hemorrhages.Results:1. The basic characteristics of the high-risk newborns’ retinal screening with RetCam Ⅱ:The retina was light gray or light pink color, the optic disc was small,the macular’s color was dark red and the fovea’s reflector was not clear. The retinal hemorrhages were almost shallow bleeding and much deep round dot were scattered all over in the retina. The bleeding won’t only scattered aroud the optic disc, but also had vessels bursting bleeding in the peripheral retina and vitreous hemorrhage.2. The incidence of retinal hemorrhage:Among123newborns,19neonates30eyes had retinal hemorrhage, and the incidence of retinal hemorrhage in newborns was12.2%.3. The shape and outcome of retinal hemorrhage:The shape of high-risk newborns’ retinal hemorrhage was most of round dot bleeding. Thy were mostly Ⅱ degrees, it average absorption times were2weeks, and the absorption time were positively associated with the degree of bleeding.4. The delivery way and retinal hemorrhages:Among49newborns who were came through spontaneous delivery,18neonates29eyes had retinal hemorrhage, the incidence of retinal hemorrhage was29.6%,while neonates from74who were born by caesarean section suffered from retinal hemorrhage only1neonate leye and the incidence of retinal hemorrhage was0.7%. The difference was statistically significant.(χ2=34.763P=0.000).5. Among the disease which high-risk neonatal suffered from, the intracranial hemorrhage of neonates had4cases,4neonates3eyes had retinal hemorrhage, the incidence of retinal hemorrhage was87.5%, while neonates from119who didn’t suffered from intracranial hemorrhage, the retinal hemorrhage had15neonate23eyes and the incidence of retinal hemorrhage was9.7%. The difference is statistically significant.(χ2=20.981, P=0.000).6. Logistic regression equation analysis tip:The risk factors of retinal hemorrhage were the birth canal squeeze, premature delivery and intracranial hemorrhage.Conclusions:1. The incidence of high-risk newborn retinal hemorrhage was12.2%,and the bleeding can often absorbed without trace, but need to keep a close follow-up.2. The high-risk newborn with intracranial hemorrhage were often accompanied by retinal hemorrhage.3. The birth canal squeeze and accompanied by intracranial hemorrhage were important factors associated with high risk newborn retinal hemorrhage.4. The wide area digital fundus imaging system (RetCam Ⅱ) had the superiority for the neonates’retinal screening.