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Related Experiment Videos

Birth trauma: incidence and predisposing factors.

M G Levine, J Holroyde, J R Woods

    Obstetrics and Gynecology
    |June 1, 1984
    PubMed
    Summary

    This study identified key risk factors for birth injuries like brachial plexus injury and fractured clavicles in newborns. Early identification of these factors can help prevent and manage these common birth traumas.

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    Area of Science:

    • Obstetrics and Gynecology
    • Neonatal Medicine
    • Pediatric Surgery

    Background:

    • Birth injuries such as brachial plexus injury, clavicular fracture, and facial nerve injury are significant concerns in neonatal care.
    • Understanding the incidence and predisposing factors of these mechanical birth traumas is crucial for risk assessment and prevention.

    Purpose of the Study:

    • To determine the incidence of brachial plexus injury, clavicular fracture, and facial nerve injury in singleton, full-term, live births.
    • To identify fetal, maternal, and intrapartum factors associated with these birth injuries.
    • To develop a risk assessment profile for identifying fetuses at risk of mechanical birth trauma.

    Main Methods:

    • Retrospective study of 13,870 singleton, full-term, consecutive live births.

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  • Analysis of birth injury data using International Classification of Diseases (ICD) codes 761.
  • Logistic regression analysis to identify associations between complications and fetal injury.

    • Main Results:

    • Incidence rates: brachial plexus injury (2.6/1000), fractured clavicle (2.0/1000), and facial nerve injury (7.5/1000).
    • Predominant risk factors identified: midforceps delivery, shoulder dystocia, low forceps delivery, infants >3500g, and prolonged second stage of labor (>60 minutes).
    • A risk assessment profile successfully identified over 50% of injured infants and 84% of uninjured infants.

    Conclusions:

    • Midforceps, shoulder dystocia, low forceps, macrosomia, and prolonged labor are significant risk factors for birth injuries.
    • A developed risk assessment profile can aid in identifying high-risk infants.
    • Obstetricians should communicate identified risk factors to pediatricians for early recognition and treatment of birth injuries.