Newborn retinal hemorrhages: A systematic review

Birth-related retinal hemorrhages in healthy full-term newborns and their relationship to maternal, obstetric, and neonatal risk factors

“…The results of the meta-analysis by Walts [3] showed that infants delivered by CS were less likely to develop RH, with 7.7 % of Cesarean births developing RH compared to 25.8 % infants delivered by SVD. Delivery via instrument was found to be another risk factor, as 35.5 % of births via instrument developed RH compared to the 25.6 % of SVD births without instrument that developed RH (OR=1.75) [3]. The present study included more potential neonatal, maternal, and obstetric risk factors than most previous studies.…”

“…As a result of such improvements, the prevalence of newborn retinal hemorrhages (RH) has been expected to decrease. However, the reported incidence of neonatal RH remains high, though it varies widely from 2.6 to 50 % [1][2][3]. This variation may be due to different examination techniques, diverse patient demographics, or how soon after birth examinations are conducted [4].…”

The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma

“…The most common cause of retinal hemorrhage is trauma in the form of birth "trauma" in newborns and abusive head trauma in infants and children [3,15]. Both the presence and increasing severity of retinal hemorrhages are associated with increased odds of inflicted versus accidental injury in children with intracranial hemorrhage, especially in children younger than 6 months of age [8,9,16].…”

“…Overall, approximately one-third of newborns examined in the first two days of life have retinal hemorrhages; the proportion is higher in vacuum-assisted delivery (42.6%) and lower in vaginal deliveries (25.6%) [15]. Intraretinal hemorrhages begin to clear very quickly, so the proportion of neonates with retinal hemorrhage drops quickly with each week postpartum.…”

Alternate theories of causation in abusive head trauma: What the science tells us

“…These clear spontaneously, usually within 6 weeks. Interpretation of retinal hemorrhages in newborns should take this into account [48]. Conditions that have not been found to cause retinal hemorrhages similar to those found in abusive head trauma include seizure, resuscitation, hypoxia and increased intracranial pressure [47].…”