Obstetric brachial plexus injury: risk factors related to recovery.
OBJECTIVE
To investigate if multivariate risk calculation can discriminate those infants who do not recover after an obstetric brachial plexus injury (OBPI).


METHODS
All liveborn infants without lethal congenital abnormalities from 1988 through 1996 with a gestational age > or =30 weeks were included. Outcome variables were all OBPI and non-recovered OBPI. Risk calculation was performed by univariate analysis for all infants and by multivariate logistic analysis for all singleton infants delivered vaginally in cephalic presentation.


RESULTS
A total of 62 of 13 366 liveborn infants sustained an OBPI (0.46%). Seventeen (27%) did not recover completely. Birth weight, female sex, second stage >60 min, diabetes, multiparity, maternal age and non-Caucasian origin were important risk factors for non-recovered OBPI. A model without birth weight, which can not be measured accurately antepartum, is considerably less effective. Risk factors for all OBPI and for non-recovered OBPI were similar.


CONCLUSIONS
A predictive multivariate model is of limited value due to the low incidence of non-recovered OBPI. However, it may be useful to discriminate individual cases with exceptional risk.
Wolf
H
H
Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, The Netherlands. h.wolf@amc.uva.nl
Hoeksma
A F
AF
Oei
S L
SL
Bleker
O P
OP
D000328:Adult; D001720:Birth Injuries; D001724:Birth Weight; D001917:Brachial Plexus / Q000293:injuries*; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007746:Labor Presentation; D007748:Labor Stage, Second; D008297:Male; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors