title: Reappraisal of neonatal clavicular fracture. Relationship between infant size and risk factors.
abstract: OBJECTIVE
  To examine the role of fetal size in neonatal clavicular fracture.
  
  
  METHODS
  A retrospective, case-control study was performed on infants diagnosed with neonatal clavicular fractures and born vaginally between July 1997 and June 2000. For each index case, a control matched for gestational age (within one week) and birth weight (within 250 g) and delivered within the same 24-hour period was selected at random from the delivery suite registry. The maternal and intrapartum factors were compared and the results analyzed according to whether the infants were large for gestational age (LGA) or not.
  
  
  RESULTS
  Among 9,540 neonates delivered vaginally during this period, 151 (1.6%) had a fractured clavicle. Multivariate analysis indicated that the independent risk factors were shoulder dystocia and vacuum extraction. When analyzed according to fetal size, shoulder dystocia was significant only for LGA infants, while vacuum extraction was significant only for non-LGA infants.
  
  
  CONCLUSIONS
  Independent risk factors for neonatal clavicular fracture are related to fetal size.
authors.affiliation: Department of Obstetrics and Gynaecology, Tsan Yuk Hospital, Hong Kong S.A.R., P.R.C. f1592821@netvigator.com
authors.forename: Man-Ho
authors.initials: MH
authors.lastname: Lam
authors.forename: Grace Y
authors.initials: GY
authors.lastname: Wong
authors.forename: Terence T
authors.initials: TT
authors.lastname: Lao
mesh_terms: D000328:Adult; D044466:Asian People; D001724:Birth Weight; D001827:Body Height; D016022:Case-Control Studies; D002968:Clavicle / Q000293:injuries*; D004420:Dystocia / Q000150:complications; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D005865:Gestational Age; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012784:Shoulder Fractures / Q000453:epidemiology* / Q000209:etiology; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data