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Birth injuries: incidence and predisposing factors
1Department of Obstetrics and Surgery, Satakunta Central Hospital, Pori, Finland.
Insights
Birth injuries affect over 3% of newborns, with clavicle fractures being most common. Macrosomia and shoulder dystocia are key causes of brachial plexus injury.
Area of Science:
- Perinatal Medicine
- Neonatal Trauma
- Pediatric Orthopedics
Background:
- Birth-associated major injuries represent a significant concern in obstetrics.
- Understanding the incidence and causes of these injuries is crucial for improving neonatal outcomes.
Purpose of the Study:
- To present the incidence of birth-associated major injuries in a large cohort of live-born infants.
- To identify the most common types of birth injuries and their associated risk factors.
Main Methods:
- Retrospective analysis of major birth injuries over a seven-year period.
- Inclusion of 14,265 live-born infants in the study population.
- Categorization and frequency calculation of different injury types.
Main Results:
- The overall incidence of major birth trauma was 3.16% (441 injuries in 437 infants).
- Clavicle fractures were the most frequent injury (3.0%), followed by brachial plexus injury (0.11%) and long bone fractures (0.03%).
- Macrosomia (4.7% incidence) and shoulder dystocia were identified as primary causes of brachial plexus injury.
Conclusions:
- Birth injuries, particularly clavicle fractures, are relatively common.
- Macrosomia and shoulder dystocia are significant risk factors for severe birth injuries like brachial plexus injury.
- The observed frequency of macrosomia in this cohort warrants further investigation and highlights potential areas for intervention.
Abstract:
The incidence of birth-associated major injuries among 14.265 live born infants during seven years is presented. The occurrence of major trauma was 3.16% or 441 injuries in 437 children. The most usual injury was fracture of the clavicle, which occurred in 3.0%, after that brachial plexus injury with occurrence of 0.11%, and fracture of long bones with 0.03%. In addition to that there was one child with facial nerve palsy. Four children had two birth injuries each. The most important causes of brachial plexus injury were macrosomia and shoulder dystocia. Eight of 16 children with brachial plexus injury had shoulder dystocia and six of 16 macrosomia. The frequency of macrosomia in our material of 14.265 children was 4.7%, which is much higher than earlier reports by other authors.