title: Neonatal clavicle fracture in cesarean delivery: incidence and risk factors.
abstract: BACKGROUND
  Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied.
  
  
  METHODS
  We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance.
  
  
  RESULTS
  Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000  g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture.
  
  
  CONCLUSIONS
  Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery.
authors.affiliation: a Department of Pediatrics , Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine , Seoul , Korea.
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Choi
authors.affiliation: a Department of Pediatrics , Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine , Seoul , Korea.
authors.forename: Yeon Kyung
authors.initials: YK
authors.lastname: Lee
authors.affiliation: a Department of Pediatrics , Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine , Seoul , Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Ko
authors.affiliation: a Department of Pediatrics , Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine , Seoul , Korea.
authors.forename: Son Moon
authors.initials: SM
authors.lastname: Shin
mesh_terms: D001720:Birth Injuries / Q000209:etiology*; D002585:Cesarean Section / Q000009:adverse effects*; D002968:Clavicle / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Cesarean delivery; clavicle fracture; incidence; neonate; risk factor