title: Risk factors for neonatal brachial plexus paralysis.
abstract: OBJECTIVE
  The study was aimed to identify risk factors for neonatal brachial plexus paralysis.
  
  
  METHODS
  A retrospective case-control study was designed. A comparison was performed between cases of brachial plexus paralysis, with all consecutive deliveries during the same 5 months period, without brachial plexus paralysis. Statistical analysis was performed using the SPSS package.
  
  
  RESULTS
  The prevalence of brachial plexus paralysis was 1.62/1,000 (9/5,525) vaginal births. Independent risk factors for brachial plexus paralysis were shoulder dystocia (OR = 525; 95% CI 51-4,977, P < 0.001), vacuum delivery (OR = 16.4; 95% CI 3.7-70.5, P < 0.001), macrosomia (birth weight >4,000 g; OR = 16.3; 95% CI 3.7-70.2, P < 0.001), prolonged second stage (OR = 40.8; 95% CI 7.9-188.2, P < 0.001) and vaginal breech delivery (OR = 36.1; 95% CI 4.5-262.5, P = 0.032).
  
  
  CONCLUSIONS
  In our population, shoulder dystocia, macrosomia, labor dystocia, vacuum delivery and vaginal breech deliveries were significant risk factors for neonatal brachial plexus paralysis, while maternal characteristics such as obesity and diabetes were not. Despite our growing knowledge concerning the risk factors associated with brachial plexus paralysis, unfortunately, this condition cannot be predicted or prevented.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Be'er Sheva, Israel. okby@bgu.ac.il
authors.forename: Rania
authors.initials: R
authors.lastname: Okby
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology* / Q000209:etiology; D001917:Brachial Plexus / Q000293:injuries; D020516:Brachial Plexus Neuropathies / Q000453:epidemiology* / Q000209:etiology; D001946:Breech Presentation / Q000453:epidemiology; D004420:Dystocia / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second; D010243:Paralysis / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012782:Shoulder; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects / Q000706:statistics & numerical data; D055815:Young Adult