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Demographics and deprivation in obstetric brachial plexus palsy: a retrospective cohort study
Claire Madeline Hardie1,2, Grainne Bourke1,2,3,4, Emily Salt1,2
1Leeds Institute for Medical Research, University of Leeds, Leeds, UK.
Insights
Neighborhood deprivation is linked to obstetric brachial plexus palsy (OBPP). Infants from the most deprived areas were over-represented, suggesting a need for targeted health interventions for at-risk maternal and infant groups.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Public Health
Background:
- Obstetric brachial plexus palsy (OBPP) is a significant birth injury.
- Socioeconomic factors, such as neighborhood deprivation, may influence OBPP incidence.
- Understanding these associations can inform public health strategies.
Purpose of the Study:
- To investigate the relationship between socioeconomic deprivation and OBPP.
- To identify potential risk factors associated with OBPP in deprived populations.
- To explore the correlation between deprivation, maternal diabetes, and age at assessment.
Main Methods:
- Retrospective observational study of 321 infants with OBPP (2008-2020).
- Utilized the Index of Multiple Deprivation (IMD) based on birth postcode.
- Analyzed associations between IMD, OBPP, gestational diabetes, and patient age at referral/assessment.
Main Results:
- A significant over-representation of OBPP cases (39%) was found in the most deprived quintile (top 20% IMD).
- Maternal diabetes (15%) and surgical exploration (31%) were noted, but not directly associated with IMD.
- No significant association was found between IMD score and maternal diabetes or age at referral/assessment.
Conclusions:
- Neighborhood deprivation is associated with an increased risk of obstetric brachial plexus palsy.
- The underlying mechanisms linking deprivation and OBPP require further investigation.
- Findings suggest a need for targeted health interventions for socioeconomically disadvantaged mothers and infants.
Abstract:
The present study analyses the relationships between deprivation and obstetric brachial plexus palsy (OBPP). A retrospective observational study was conducted of infants with OBPP seen between 2008 and 2020 (n = 321). The index of multiple deprivation (IMD) was used to assign an IMD rank to patients based on birth postcode and the relationship with OBPP was analysed, including deprivation, gestational diabetes, age at referral and at first assessment. Quintile-based analysis demonstrated over-representation of patients from more deprived neighbourhoods (n = 109, 39%) living in the top 20% most deprived neighbourhoods. A total of 48 (15%) mothers had diabetes and 98 (31%) infants underwent surgical brachial plexus exploration (a marker of disease severity). Neither diabetes, age at referral nor age at first assessment were associated with IMD score. This suggests that neighbourhood deprivation is associated with OBPP, though the mechanisms are unclear. Further studies in this area may enable targeted health intervention for more deprived maternal and infant groups.Level of evidence: III.
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