title: [Birth-related retinal hemorrhages in the newborn: incidence and relationship with maternal, obstetric and neonatal factors. Prospective study of 2,031 cases].
abstract: OBJECTIVE
  To assess the prevalence, morphology and distribution of retinal hemorrhages in healthy newborns and their relationship to neonatal, maternal and obstetrical factors, and to determine their natural history.
  
  
  METHODS
  The present study prospectively included 2,031 consecutive healthy newborns. Indirect ophthalmoscopy was performed within 24 hours after birth in all newborns. Infants with retinal hemorrhages were reexamined weekly until the hemorrhage resolved. Annual ophthalmologic follow-up was also scheduled in these children. Neonatal, maternal and obstetric parameters were analyzed in all newborns and compared between newborns with retinal hemorrhages and those without retinal hemorrhages.
  
  
  RESULTS
  31.8 % of newborns exhibited retinal hemorrhages. 72.6 % of hemorrhages were bilateral. They tended to be localized around the optic discs and in the posterior pole, but their distribution was variable. Retinal hemorrhages were of variable shapes. The prevalence of retinal hemorrhages was higher in newborns delivered with vacuum-assisted extraction (38 %, P<0.001), intermediate during normal vaginal delivery (32.6 %, P<0.001) and lower with cesarean section (20.8 %). Comparative analysis between elective cesarean section and emergency cesarean showed a higher incidence of retinal hemorrhages in the emergency cesarean group (P=0.006). On multivariate analysis, vacuum-assisted delivery was the only factor associated with a higher prevalence of retinal hemorrhages in newborns (P=0.045). Two thirds of hemorrhages had disappeared by one week after birth. Retinal hemorrhages had resolved in all newborns within four weeks.
  
  
  CONCLUSIONS
  Birth-related retinal hemorrhages are common (1/3 of our newborns). Vacuum-assisted delivery is the main risk factor in this study. All hemorrhages resolved by one month of age. These findings may help in differential diagnosis with shaken baby syndrome.
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Laghmari
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: H
authors.initials: H
authors.lastname: Skiker
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc. Electronic address: hhandor@yahoo.fr.
authors.forename: H
authors.initials: H
authors.lastname: Handor
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: B
authors.initials: B
authors.lastname: Mansouri
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: K
authors.initials: K
authors.lastname: Ouazzani Chahdi
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: R
authors.initials: R
authors.lastname: Lachkar
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: Y
authors.initials: Y
authors.lastname: Salhi
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: O
authors.initials: O
authors.lastname: Cherkaoui
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: B
authors.initials: B
authors.lastname: Ouazzani Tnacheri
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: W
authors.initials: W
authors.lastname: Ibrahimy
authors.affiliation: Centre national de santé de reproduction, maternité des Orangers, avenue du Président Soekarno, Rabat, Maroc.
authors.forename: H
authors.initials: H
authors.lastname: Alami
authors.affiliation: Centre national de santé de reproduction, maternité des Orangers, avenue du Président Soekarno, Rabat, Maroc.
authors.forename: R
authors.initials: R
authors.lastname: Bezad
authors.affiliation: Laboratoire de biostatiques et de recherche clinique et épidémiologiques (LBRCE), faculté de médecine et de pharmacie de Rabat, université Mohammed V-Souissi, Angle avenue Allal El Fassi et Mfadel Cherkaoui, Al Irfane 8007 NU, Rabat, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Ahid
authors.affiliation: Laboratoire de biostatiques et de recherche clinique et épidémiologiques (LBRCE), faculté de médecine et de pharmacie de Rabat, université Mohammed V-Souissi, Angle avenue Allal El Fassi et Mfadel Cherkaoui, Al Irfane 8007 NU, Rabat, Maroc.
authors.forename: R
authors.initials: R
authors.lastname: Abouqal
authors.affiliation: Service d'ophtalmologie, hôpital des spécialités, centre hospitalier Ibn Sina (CHIS), rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
authors.forename: R
authors.initials: R
authors.lastname: Daoudi
mesh_terms: D001720:Birth Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011248:Pregnancy Complications; D015995:Prevalence; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology*
keywords: Accouchement; Hémorragies rétiniennes; Labor and delivery; Newborn; Nouveau-né; Retinal hemorrhages