Performing red reflex eye examinations increases the rate of neonatal conjunctivitis.
2015
Aim
Red reflex
eye examinationsoften require opening the eyelids, risking infection. We evaluated links between this procedure and
neonatal conjunctivitis. Methods We divided 18 872 neonates of more than 35 weeks of gestation into two birth periods, 2008–2009 and 2010–2011, before and after
red reflexexaminations were carried out by our facility. The rates of clinical conjunctivitis, bacterial conjunctivitis and
bacterial growthpercentage were compared between the two periods. Results The 2010–2011 period included more
Caesarean deliveriesand longer lengths of stay (LOS) than the 2008–2009 period. The clinical conjunctivitis rate increased significantly during 2010–2011 (p = 0.029), but the bacterial conjunctivitis and
bacterial growthpercentages did not differ between the two periods. Variables that were independently and significantly associated with clinical conjunctivitis included being born in 2010–2011, with an odds ratio (OR) of 1.22, male gender (OR 1.31) and LOS (OR 1.19). Bacterial conjunctivitis was associated with vaginal delivery (OR 3.65), males delivered by Caesarean (OR 2.68) and LOS (OR 1.37). Conclusion Clinical conjunctivitis was significantly associated with the later study period, male gender and LOS. Conjunctival swab sampling increased significantly following the implementation of
red reflexexaminations, but without changes in the bacterial conjunctivitis rate and the
bacterial growthpercentage.
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