title: Characteristics and outcome of brachial plexus birth palsy in neonates.
abstract: OBJECTIVE
  To relate pregnancy characteristics to extent and reversibility of brachial plexus birth palsy (BPBP) in neonates.
  
  
  METHODS
  Retrospective case-control study: newborns with a registered diagnosis of BPBP (n = 168) 1990-2005 were compared to data from a randomly selected control group (n = 1000). Characteristics were related to the level of injury, reversibility and outcome.
  
  
  RESULTS
  Among 51,841 newborns, 168 cases with BPBP were found (incidence 3.2/1000 newborns/year). Extent and reversibility of lesion did not differ with respect to characteristics of mothers, foetuses or deliveries. Children with C5-C6 and C5-C6-C7 injuries had complete recovery in 86% and 38%, respectively. Global injuries (C5-Th1) always had permanent disability. Accelerators (foetal weight gain >35 g/day after 32 weeks of gestation) and foetuses with estimated weight deviation ≥ +22% at 32 weeks were at seven- and ninefold increased risk of BPBP. Parous women were at doubled risk as compared to nulliparous women.
  
  
  CONCLUSIONS
  Maternal and foetal characteristics influence risk of BPBP, but not the extent of injury or reversibility of injury. Because of the high risk of permanent disability and modest risk of low Apgar or pH among newborns with BPBP, the recommendation of prompt delivery may need to be re-evaluated.
authors.affiliation: Department of Obstetrics and Gynecology, Clintec, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Pelle G
authors.initials: PG
authors.lastname: Lindqvist
authors.forename: Kristina
authors.initials: K
authors.lastname: Erichs
authors.forename: Cecilia
authors.initials: C
authors.lastname: Molnar
authors.forename: Saemundur
authors.initials: S
authors.lastname: Gudmundsson
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
mesh_terms: D001720:Birth Injuries / Q000175:diagnosis / Q000628:therapy; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000628:therapy; D016022:Case-Control Studies; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies