Neonatal subgaleal hemorrhage in a multihospital healthcare system: twenty years of trends in incidence, associations, and outcomes

Abstract BACKGROUND: In 2011 we reported 38 neonates with subgaleal hemorrhage (SH), relating that our incidence appeared to be increasing. DESIGN: We retrospectively analyzed every recognized case of SH in our hospitals from the end of our previous report to the present. We redescribed the incidence, compared severity to fetal/neonatal and obstetrical features, tabulated the blood products transfused, and recorded the outcomes at two-years.RESULTS: Across 141 months, 191 neonates were diagnosed with SH; 30 after vacuum or forceps. The overall incidence (one case/1815 births) was higher than in our 2011 report (one case/7124 births). Also, the incidence of severe SH (requiring transfusions) was higher (one case/10,033 births) than in our previous report (one case/20,950 births). Four died (all with severe SH) and 12 had neurodevelopmental impairment at two years. CONCLUSION: Recognized cases of SH are increasing in our healthcare system, without a clear explanation. Adverse outcomes are rare but continue to occur.