Risk factors for neonatal brachial plexus paralysis.
Summary of "Risk factors for neonatal brachial plexus paralysis."
PURPOSE:
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.
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.
Journal Details
This article was published in the following journal.
Name: Archives of gynecology and obstetrics
ISSN: 1432-0711
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22437188
- DOI: http://dx.doi.org/10.1007/s00404-012-2272-z
Medical and Biotech [MESH] Definitions
Brachial Plexus Neuritis
A syndrome associated with inflammation of the BRACHIAL PLEXUS. Clinical features include severe pain in the shoulder region which may be accompanied by MUSCLE WEAKNESS and loss of sensation in the upper extremity. This condition may be associated with VIRUS DISEASES; IMMUNIZATION; SURGERY; heroin use (see HEROIN DEPENDENCE); and other conditions. The term brachial neuralgia generally refers to pain associated with brachial plexus injury. (From Adams et al., Principles of Neurology, 6th ed, pp1355-6)
Brachial Plexus
The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.
Cervical Rib Syndrome
A condition associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the thoracic outlet and caused by a complete or incomplete anomalous CERVICAL RIB or fascial band connecting the tip of a cervical rib with the first thoracic rib. Clinical manifestations may include pain in the neck and shoulder which radiates into the upper extremity, PARESIS or PARALYSIS of brachial plexus innervated muscles; sensory loss; PARESTHESIAS; ISCHEMIA; and EDEMA. (Adams et al., Principles of Neurology, 6th ed, p214)
Thoracic Outlet Syndrome
A neurovascular syndrome associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the superior thoracic outlet. This may result from a variety of anomalies such as a CERVICAL RIB, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, PARESIS or PARALYSIS of brachial plexus innervated muscles, PARESTHESIA, loss of sensation, reduction of arterial pulses in the affected extremity, ISCHEMIA, and EDEMA. (Adams et al., Principles of Neurology, 6th ed, pp214-5).
Brachial Plexus Neuropathies
Diseases of the cervical (and first thoracic) roots, nerve trunks, cords, and peripheral nerve components of the BRACHIAL PLEXUS. Clinical manifestations include regional pain, PARESTHESIA; MUSCLE WEAKNESS, and decreased sensation (HYPESTHESIA) in the upper extremity. These disorders may be associated with trauma (including BIRTH INJURIES); THORACIC OUTLET SYNDROME; NEOPLASMS; NEURITIS; RADIOTHERAPY; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp1351-2)
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