A comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies.
OBJECTIVE
To estimate differences between shoulder dystocia-associated transient and permanent brachial plexus palsies.


METHODS
We performed a retrospective case-control analysis from national birth injury and shoulder dystocia databases. Study patients had permanent brachial plexus palsy and had been entered into a national birth injury registry. Cases of Erb or Klumpke palsy with documented neonatal neuromuscular deficits persisting beyond at least 1 year of life were classified as permanent. Cases of transient brachial plexus palsy were obtained from a shoulder dystocia database. Non-shoulder dystocia-related cases of brachial plexus palsy were excluded from analysis. Cases of permanent brachial plexus palsy (n=49) were matched 1:1 with cases of transient brachial plexus palsy.


RESULTS
Transient brachial plexus palsy cases had a higher incidence of diabetes mellitus than those with permanent brachial plexus palsy (34.7% versus 10.2%, odds ratio [OR] 4.68, 95% confidence interval [CI] 1.42, 16.32). Patients with permanent brachial plexus palsies had a higher mean birth weight (4519+/-94.3 g versus 4143.6+/-56.5 g, P<.001) and a greater frequency of birth weight greater than 4500 grams (38.8% versus 16.3%, OR, 0.31, 95% CI 0.11, 0.87). There were, however, no statistically significant differences between the two groups with respect to multiple antepartum, intrapartum, and delivery outcome measures.


CONCLUSIONS
Transient and permanent brachial plexus palsies are not associated with significant differences for most antepartum and intrapartum characteristics.
Gherman
Robert B
RB
Department of OB/GYN, Division of Maternal/Fetal Medicine, National Naval Medical Center, Bethesda, Maryland, USA.
Ouzounian
Joseph G
JG
Satin
Andrew J
AJ
Goodwin
T Murphy
TM
Phelan
Jeffrey P
JP
D000208:Acute Disease; D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002908:Chronic Disease; D016001:Confidence Intervals; D004420:Dystocia / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D015601:Injury Severity Score; D016017:Odds Ratio; D010246:Paralysis, Obstetric / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011336:Probability; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D000070599:Shoulder Injuries