Incidence of Retinal Hemorrhage in Newborns With Intrauterine Growth Restriction (IUGR) at King Fahad Armed Forces Hospital, Jeddah

Objective The objective of this study is to evaluate the incidence and associated risk factors of neonatal retinal hemorrhage (NRH) and, secondarily, to describe its clinical characteristics, laterality, and severity in newborns with intrauterine growth restriction (IUGR) from January 2017 to December 2021 at a tertiary center in Jeddah, Saudi Arabia. Methods This study was conducted using a retrospective chart review of all newborns with IUGR from January 2017 to December 2021 at King Fahad Armed Forces Hospital (KFAFH) in Jeddah, Saudi Arabia. Clinical records including demographics, neonatal as well as maternal factors, and ophthalmological exams were reviewed. Results Among 1775 newborns with IUGR, 62 (3.5%) newborns had positive findings of NRH. The incidence rate of NRH was 6.98 per 1000 live births (0.698%) per year. NRH was more commonly found bilaterally (36; 58.1%), in female newborns (43; 69.4%), and in those born through spontaneous vaginal delivery (SVD) (45; 72.6%). Most cases, 52 (83.9%), involved multiple retinal hemorrhage points rather than a single point (10; 16.1%). A higher gestational age (GA), which corresponds to a higher birth weight, was linked to an increased risk of retinal hemorrhages. The presence of jaundice, RDS, or neonatal hematological diseases was significantly associated with the development of NRH. Conclusion NRH is relatively common in infants with IUGR, usually resolving spontaneously without affecting vision. Its occurrence was associated with a higher GA, SVD, jaundice, respiratory distress syndrome, and hematological disorders. Targeted screening of IUGR infants with these risk factors may support early detection, though further research is needed to clarify prognostic and preventive strategies.