title: Persistence of Neonatal Brachial Plexus Palsy Associated with Maternally Reported Route of Delivery: Review of 387 Cases.
abstract: Objective The factors associated with persistent neonatal brachial plexus palsy (PNBPP) are unknown. Our objectives are to compare PNBPP at 1 and 2 years in children delivered via vaginal delivery (VD) versus cesarean delivery (CD) and in children delivered via VD with or without reported shoulder dystocia (SD). Study Design Retrospective cohort of children diagnosed with neonatal brachial plexus palsy (NBPP). Maternally reported delivery history and presence of SD were recorded with Student t-test, chi-square test, and odds ratio (OR) with 95% confidence intervals (CI) calculated for comparisons. Results Of 387 cases of NBPP, 8% (30) delivered via CD. Rates of PNBPP were higher in the VD group at 1 and 2 years (60% of CD and 85% of VD; OR, 0.26; 95% CI, 0.11-0.62 at 1 year; 33% of CD and 73% of VD; OR, 0.15; 95% CI, 0.05-0.39 at 2 years). There was no difference in PNBPP in women with VD with or without maternally reported SD (87 vs. 85%, p = 0.68 at 1 year; 64 vs. 61%, p = 0.61 at 2 years). Conclusion PNBPP is possible with CD, and there is no difference in PNBPP in VD with or without maternally reported SD. A prospective study is warranted to ascertain associative factors.
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kate W-C
authors.initials: KW
authors.lastname: Chang
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Nana-Ama E
authors.initials: NA
authors.lastname: Ankumah
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wilson
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lynda J-S
authors.initials: LJ
authors.lastname: Yang
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000453:epidemiology*; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data*; D004420:Dystocia / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008824:Michigan / Q000453:epidemiology; D036801:Parturition; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012782:Shoulder; D013997:Time Factors; D055815:Young Adult