Abstract
OBJECTIVE:Neonatal clavicle fracture has been previously reported to occur in association with shoulder dystocia, suggesting liability on behalf of the obstetrician. However, clavicle fracture is often inconsistently diagnosed, and shoulder dystocia commonly subjectively defined. Using a formal pediatric diagnosis protocol and an objective definition of shoulder dystocia, we sought to determine the incidence, antecedents, and associated morbidities of clavicle fracture and the potential association with shoulder dystocia.
STUDY DESIGN:All deliveries at Harbor-UCLA Medical Center complicated by clavicle fracture from January 1996 to March 1999 were studied. Deliveries with clavicle fracture were compared to all vaginal deliveries during this period.
RESULTS:Among 4297 deliveries, twenty-six were complicated by clavicle fracture (0.5%). Clavicle fracture was significantly associated with increased maternal age and birth weight greater than 4 kg, though not associated with shoulder dystocia or operative vaginal delivery. Clavicle fracture was associated with meconium passage and with neonatal orthopedic abnormalities.
CONCLUSION:Neonatal clavicle fracture is associated with infant birth weight greater than 4 kg, but not with the occurrence of objectively defined shoulder dystocia. However, infants with clavicle fracture may be at increased risk for additional complications.
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References
Seeds JW, Walsh M Malpresentations In: Gabbe S, Niebyl J, Simpson JL, editors Obstetrics: Normal and Problem Pregnancies 3rd ed New York: Livingstone 1996 p. 494
Kaplan B, Rabinerson D, Averch OM, Carmi N, Steinberg DM, Merlob P Fracture of the clavicle in the newborn following normal labor and delivery Int J Obstet Gynecol 1998 63 15–20
Roberts SW, Hernandez C, Maberry MC, Adams MD, Leveno KJ, Wendel GD Obstetric clavicle fracture: the enigma of normal birth Obstet Gynecol 1995 86 978–81
Peleg D, Hasnin J, Shalev E Fractured clavicle and Erb's palsy unrelated to birth trauma Am J Obstet Gynecol 1997 177 1038–40
Joseph P, Rosenfeld W Clavicular fracture in neonates Am J Dis Child 1990 144 165–7
Many A, Brenner SH, Yaron Y, Lusky A, Peyser MR, Lessing JB Prospective study of incidence and predisposing factors for clavicle fracture in the newborn Acta Obstet Gynecol Scand 1996 75 378–81
Beall MH, Spong C, McKay J, Ross MG Objective definition of shoulder dystocia: a prospective evaluation Am J Obstet Gynecol 1998 179 934–7
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Presented at the Society for Maternal–Fetal Medicine Annual Meeting, February 1–5, 2000, Miami, FL, USA.
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Beall, M., Ross, M. Clavicle Fracture in Labor: Risk Factors and Associated Morbidities. J Perinatol 21, 513–515 (2001). https://doi.org/10.1038/sj.jp.7210594
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DOI: https://doi.org/10.1038/sj.jp.7210594
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