He Cong, Liao Yuanqiao, He Xinyang, Ye Zhenwei, Su Shaosheng, Zhang Yanli
Department of Ophthalmology, Aier Eye Hospital, Jinan University, Guangzhou, Guangdong, 510000, People's Republic of China.
Information Department, Zhongshan City People's Hospital, Zhongshan, Guangdong, 528406, People's Republic of China.
Int J Gen Med. 2025 Mar 27;18:1747-1756. doi: 10.2147/IJGM.S505664. eCollection 2025.
Neonatal white-centered retinal hemorrhage (NWCRH) is characterized by white or yellowish-white central spots within retinal hemorrhages, resembling Roth spots. Elucidating the etiological factors may enhance preventive strategies and deepen understanding of NWCRH. This study examined correlations between NWCRH and perinatal maternal conditions, delivery factors, and neonatal characteristics.
From January 2013 to December 2015, neonates delivered at the Department of Obstetrics at Zhongshan People's Hospital underwent RetCam III fundus screening within four days postpartum were enrolled. Demographic and clinical information of neonates and mothers were collected, and univariate and multivariate logistics regression analyses were used to explore the influencing factors of NWCRH and its severity.
WCRH was identified in 574 out of 3606 neonates (15.92%), with retinal hemorrhage detected in 868 cases (24.07%). For Grade I retinal hemorrhage, 441 cases were documented, with WCRH present in 169 cases (38.32%). For Grade II retinal hemorrhage, 239 cases were recorded, with 223 (93.31%) exhibiting WCRH. In Grade III retinal hemorrhage, 182 out of 188 cases (96.81%) displayed WCRH. In the multivariate analysis of Groups II and III, neonatal blood type B was found to be statistically significant for Roth spot formation. In the univariate analysis of maternal factors, gestational diabetes and hypertension were associated with an increased risk of Roth spots.
This study identified key risk factors for the formation of neonatal Roth spots, including mode of delivery, umbilical cord around the neck, and blood group B. Given its potential long-term effects on vision, early screening and preventive measures are recommended. For neonates with a history of umbilical cord around the neck and rapid delivery, fundus screening can facilitate timely intervention and improve neonatal eye health.
新生儿白色中心性视网膜出血（NWCRH）的特征是视网膜出血内有白色或黄白色中心斑点，类似 Roth 斑。阐明病因因素可能会加强预防策略并加深对 NWCRH 的理解。本研究调查了 NWCRH 与围产期母亲状况、分娩因素和新生儿特征之间的相关性。
选取 2013 年 1 月至 2015 年 12 月在中山市人民医院产科分娩且产后四天内接受 RetCam III 眼底筛查的新生儿。收集新生儿和母亲的人口统计学和临床信息，并采用单因素和多因素逻辑回归分析来探讨 NWCRH 及其严重程度的影响因素。
3606 例新生儿中有 574 例（15.92%）被诊断为 WCRH，868 例（24.07%）检测到视网膜出血。I 级视网膜出血记录了 441 例，其中 169 例（38.32%）有 WCRH。II 级视网膜出血记录了 239 例，其中 223 例（93.31%）有 WCRH。III 级视网膜出血 188 例中有 182 例（96.81%）有 WCRH。在 II 组和 III 组的多因素分析中，发现新生儿 B 型血对 Roth 斑形成具有统计学意义。在母亲因素的单因素分析中，妊娠期糖尿病和高血压与 Roth 斑风险增加有关。
本研究确定了新生儿 Roth 斑形成的关键危险因素，包括分娩方式、脐带绕颈和 B 型血。鉴于其对视力可能产生的长期影响，建议进行早期筛查和采取预防措施。对于有脐带绕颈和急产史的新生儿，眼底筛查有助于及时干预并改善新生儿眼部健康。
