title: Route of delivery and neonatal birth trauma.
abstract: OBJECTIVE
  We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery.
  
  
  METHODS
  Data on singleton infants were obtained from the 2004-2005 Healthcare Cost and Utilization Project Nationwide Inpatient Sample.
  
  
  RESULTS
  The rates of Agency for Healthcare Research and Quality PSI and all birth trauma were 2.45 and 25.85 per 1000 births, respectively. Compared with vaginal, cesarean delivery was associated with increased odds of PSI birth trauma (odds ratio [OR], 1.71), primarily due to an increased risk for "other specified birth trauma" (OR, 2.61). Conversely, cesarean delivery was associated with decreased odds of all birth trauma (OR, 0.55), due to decreased odds of clavicle fractures (OR, 0.07), brachial plexus (OR, 0.10), and scalp injuries (OR, 0.55).
  
  
  CONCLUSIONS
  Infants delivered by cesarean are at risk for different types of birth trauma from infants delivered vaginally.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA. cmoczygemba@gmail.com
authors.forename: Charmaine K
authors.initials: CK
authors.lastname: Moczygemba
authors.forename: Pangaja
authors.initials: P
authors.lastname: Paramsothy
authors.forename: Susan
authors.initials: S
authors.lastname: Meikle
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.forename: Wanda D
authors.initials: WD
authors.lastname: Barfield
authors.forename: Elena
authors.initials: E
authors.lastname: Kuklina
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Posner
authors.forename: Maura K
authors.initials: MK
authors.lastname: Whiteman
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
mesh_terms: D001720:Birth Injuries / Q000453:epidemiology*; D001724:Birth Weight; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D036801:Parturition; D011247:Pregnancy; D012307:Risk Factors; D014481:United States / Q000453:epidemiology