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Maternal race/ethnicity impacts brachial plexus birth injury (BPBI) risk. While Black and Hispanic mothers face higher risks for conditions like obesity and diabetes, these factors explain only a small part of their increased BPBI risk.

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Area of Science:

  • Obstetrics and Gynecology
  • Pediatric Neurology
  • Public Health

Background:

  • Brachial plexus birth injury (BPBI) is a significant concern in obstetrics.
  • Understanding the role of maternal demographics in BPBI risk is crucial for targeted prevention strategies.

Purpose of the Study:

  • To examine the association between maternal race/ethnicity and risk factors for brachial plexus birth injury (BPBI).
  • To quantify the extent to which identified risk factors contribute to the excess BPBI risk observed in certain racial/ethnic groups.

Main Methods:

  • Retrospective cohort study of over 6.2 million livebirths in California (1996-2012).
  • Inclusion of 7,762 cases of brachial plexus birth injury (BPBI).
  • Application of multiple logistic regression and causal mediation analyses to assess relationships.

Main Results:

  • Black and Hispanic birthing individuals exhibited increased risk for obesity, diabetes, and reduced prenatal care.
  • Conversely, these groups had a decreased risk for established BPBI risk factors like shoulder dystocia, macrosomia, prolonged second stage of labor, and vaginal delivery.

Conclusions:

  • Established BPBI risk factors mediate only a minor portion of the elevated risk in Black and Hispanic populations.
  • Highlights the need to identify novel risk factors and understand the drivers of demographic disparities in BPBI incidence.