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Assessment of Current Epidemiology and Risk Factors Surrounding Brachial Plexus Birth Palsy

Joshua M Abzug1, Charles T Mehlman2, Jun Ying3

  • 1Department of Orthopaedics, University of Maryland School of Medicine, Timonium, MD.

The Journal of Hand Surgery
|September 30, 2018
PubMed

Insights

The incidence of brachial plexus birth palsy (BPBP) is decreasing, with shoulder dystocia remaining the primary risk factor. New research identifies hypotonia as a risk factor and highlights increased hospital stays and costs for affected infants.

Area of Science:

  • Pediatric neurology
  • Obstetrics
  • Public health

Background:

  • Brachial plexus birth palsy (BPBP) affects newborns, with over 50% lacking identifiable risk factors.
  • Current incidence and associated healthcare costs for BPBP are not well-established.

Purpose of the Study:

  • To determine the current incidence of BPBP.
  • To assess known and novel risk factors, including hypotonia.
  • To evaluate the impact of BPBP on length of hospital stay (LOS) and direct costs.

Main Methods:

  • Analysis of the 1997-2012 Kids' Inpatient Database.
  • Multivariable logistic regression to identify risk factors for BPBP.
  • Evaluation of LOS and direct medical costs for affected infants.

Main Results:

  • BPBP incidence declined from 1997 to 2012, with 0.9 per 1,000 live births in 2012.
  • Shoulder dystocia is the leading risk factor; hypotonia is a newly identified risk factor.
  • Infants with BPBP experienced ~20% longer LOS and ~40% higher direct costs.

Conclusions:

  • The incidence of BPBP is decreasing.
  • Shoulder dystocia remains the most significant risk factor for BPBP.
  • BPBP is associated with increased hospital LOS and direct costs.
Abstract

Keywords:
Brachial plexus birth palsy (BPBP)obstetrical brachial plexus injury (OBPI)risk factorsshoulder dystocia

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