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Prevalence of perinatal factors in infants with brachial plexus birth injuries and their association with injury severity

Journal of Perinatology volume 43, pages 578–583 (2023)Cite this article

Subjects

Abstract

Objectives

To determine the prevalence of perinatal factors associated with brachial plexus birth injury (BPBI) in affected infants and their relationship with BPBI severity.

Study design

Retrospective study of BPBI infants prospectively enrolled in a multicenter registry. The prevalence of perinatal factors was calculated. Infants were stratified by injury severity and groups were compared to determine the association of severity and perinatal factors.

Results

Seven-hundred-ninety-six BPBI infants had a mean 4.2 ± 1.6 perinatal factors. Nearly all (795/796) reported at least one factor, including shoulder dystocia(96%), no clavicle fracture (91%), difficult delivery(84%), parity >1(61%) and birthweight >4000 g(55%). Ten-percent (74/778) had Horner’s syndrome and 28%(222/796) underwent nerve surgery. Birth asphyxia and NICU admission were significantly associated with injury severity.

Conclusions

NICU admission and asphyxia were associated with BPBI severity. An improved understanding of the relationship between perinatal factors and BPBI severity may be used to guide early referral to BPBI providers and support prevention efforts.

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Data availability

All data generated or analyzed during this study are included in this article and/or its supplementary material files. Further enquiries can be directed to the corresponding author.

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Funding

This work was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR001860 and linked award KL2 TR001859. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shriners Hospital for Children, Sacramento, CA, USA

    M. Claire Manske

  2. Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, USA

    M. Claire Manske

  3. Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, MA, USA

    Patricia E. Miller & Andrea S. Bauer

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Contributions

MCM: responsible for study conception and design, assisted in data interpretation; prepared original manuscript and subsequent revisions; has approved final manuscript and agrees to be responsible for all aspects of this work. PEM: performed the statistical analyses and interpretation; performed critical analysis of the manuscript for intellectual content; has approved final manuscript and agrees to be responsible for all aspects of this work. ASB: responsible for study conception, assisted in data interpretation, performed critical analysis of the manuscript for intellectual content; has approved final manuscript and agrees to be responsible for all aspects of this work.

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Correspondence to M. Claire Manske.

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Competing interests

The authors declare no competing interests.

Ethics

This research was conducted in accordance with the World Medical Association Declaration of Helsinki.

Consent to participate

Written informed consent was obtained from a parent/legal guardian for subjects to participate in the TOBI (Treatment and Outcomes of Brachial plexus Injury) registry. As part of the consent form, patients/parents were informed that the data collected would be used to provide valuable information about long-term outcomes of BPBI in order to inform better treatment options for patients in the future. For this reason the Institutional Review Board at Boston Children’s Hospital determined that the present study using data from the TOBI registry met the regulatory requirements necessary in order to obtain a waiver of informed consent/authorization.

Study approval statement

This study protocol was reviewed and approved by the Institutional Review Board at Boston Children’s Hospital, protocol number IRB-P00034806.

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Manske, M.C., Miller, P.E. & Bauer, A.S. Prevalence of perinatal factors in infants with brachial plexus birth injuries and their association with injury severity. J Perinatol 43, 578–583 (2023). https://doi.org/10.1038/s41372-022-01594-0

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