Кровоизлияния в сетчатку у новорожденных. Клинические особенности и факторы риска

Abstract

Material and methods. The study included newborns born at the Perinatal Center of St. Petersburg State Pediatric Medical University in the period from July 2021 to October 2022. Anamnestic and other risk factors for the development of retinal hemorrhages were assessed in newborns with and without retinal hemorrhages (RH). Depending on the severity of RH (according to the results of the examination on the RetCam retinal camera), the newborns were divided into groups in which the bilaterality of the RH was assessed, localization in the layers and area of the retina, with an emphasis on the macular region and the optic disk. Results. Of the 75 newborns, 16 had birth-related RH (23.1%). Normal spontaneous vaginal delivery showed the highest association with RH (odds ratio, 5.515; 95% confidence interval, 1.15–26.46, p<0.001). Hemorrhages were more often bilateral (68.8%), intraretinal (87.5%) and localized in the central zone of the retina (81.3%). At the same time, severe RH were more often located in zones I and II, in each newborn they affected the optic nerve or macula, in 6.3% of cases they spread to the vitreous body, and in 25% they were accompanied by Roth’s spots. Conclusion. RH occur in 21.3% of full-term newborns and are largely associated with normal delivery. The main characteristics of hemorrhages in newborns differ notably depending on their severity. Severe retinal hemorrhages in newborns may have negative consequences for the development of visual functions at an older age, which requires further long-term studies. This study confirmed that the digital wide-angle retinal camera is an effective method for examining a large number of newborns with RH. Key words: newborn, retinal hemorrhages, vitreous hemorrhages, Roth’s spots