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Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
Published on: December 19, 2019
Risk factors for persistent disability in children with obstetric brachial plexus palsy
S Zuarez-Easton1, N Zafran1,2, G Garmi1,2
1Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
Insights
Obstetric brachial plexus palsy (OBPP) is usually temporary. However, high birthweight and younger maternal age may increase the risk of long-term disability from OBPP.
Area of Science:
- Neurology
- Obstetrics
- Pediatrics
Background:
- Obstetric brachial plexus palsy (OBPP) is a significant birth injury with potential for lasting disability.
- Understanding OBPP's occurrence and risk factors is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To investigate the incidence of OBPP.
- To identify demographic and obstetric risk factors associated with disability lasting longer than one year.
Main Methods:
- Retrospective cohort study (1993-2012) of 144 OBPP cases from 83,806 deliveries.
- Motor function assessed via physical exam or telephone questionnaire.
- Logistic regression used to analyze risk factors for prolonged disability.
Main Results:
- OBPP occurred in 1.7 per 1000 births.
- Disability lasting over one year was observed in 13.2% of evaluated cases.
- Birthweight >4kg (OR 6.17) and younger maternal age (OR 0.84) were significant predictors of prolonged disability.
Conclusions:
- OBPP is typically a transient condition.
- Higher birthweight and younger maternal age are associated with increased risk of long-term disability from OBPP.
Objective:
Obstetric brachial plexus palsy (OBPP) at birth, is a serious neurologic injury that may lead to a long lasting disability. We aimed to examine the occurrence and risk factors associated with disability lasting >1 year.
Study Design:
A retrospective cohort study conducted between 1993 and 2012 included individuals with diagnosis of OBPP at birth. Affected individual's motor function was evaluated by a direct physical exam based on a muscle grading system of the limb, shoulder, elbow and hand. When not feasible a telephone questionnaire was used. Participants reported on activities of daily living, disability duration and any type of intervention. Stepwise logistic regression model was used to identify demographic and obstetric risk factors for disability lasting >1 year.
Results:
Of all 83 806 deliveries during this period, 144 OBPP cases were identified (1.7/1000). Of the 91 (63.2%) individuals located 42 (46.2%) were evaluated by a physical exam and 49 (53.8%) answered a telephone questionnaire. In 12 (13.2%) disability lasted >1 year. Significant predictors for disability lasting >1 year included birthweight >4 kg (P=0.02; odds ratio (OR) 6.17; 95% confidence interval (CI) 1.33-28.65) and younger maternal age (P=0.02; OR 0.84; 95% CI: 0.73-0.97). OBPP decreased 16% per 1 year increase in maternal age.
Conclusions:
OBPP is a transient injury in most cases. Birthweight over 4 kg and younger maternal age maybe associated with disability lasting >1 year.
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