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Publication
Neonatal Brachial Plexus Palsy: Risk Factors and Its Prognostic Value
Authors
Advisor(s)
Abstract(s)
Introduction: Neonatal brachial plexus palsy affects 0.7
to 5.8 per 1,000 newborns and is characterised by upper
limb paresis detected in the immediate neonatal period.
Shoulder dystocia, instrumental delivery and foetal
macrosomia are well-known risk factors. Most neonatal
brachial plexus palsy evolve favourably, while 3%-27% of
newborns have sequelae.
Methods: A retrospective cross-sectional study was
conducted to characterise neonatal brachial plexus
palsy in the newborn population of a hospital with
differentiated perinatal support and to assess the rela -
tionship between the risk factors and lesion prognosis.
The authors reviewed the newborn medical records
referred to the physical medicine and rehabilitation
clinic between January 2006 and December 2016.
Results: During the study period, 137 cases of neo-
natal brachial plexus palsy were identified in 36,833
births, which translate into an incidence of 3.7/1,000
live births. Foetal macrosomia was found in 41% and
shoulder dystocia in 40%. According to the Narakas clas-
sification, 58% were included in group I, 30% in group
II, 9% in group III and 3% in group IV. The majority of
patients were discharged without sequelae. Newborns
with group II, III and IV lesions as well as macrosomic
newborns were more likely to develop sequelae (p <
0.05). Shoulder dystocia and operative delivery did not
present a statistically significant relationship with the
prognosis of the lesion.
Discussion: The incidence of neonatal brachial plexus
palsy in this population was similar to is described in
other series. The relationship between macrosomia and
neonatal brachial plexus palsy with sequelae found may
be of importance in the attempt to prevent this lesion
Description
Keywords
Brachial plexus injuries Birth injuries Newborn Portugal
Citation
Acta Pediatr Port 2019;50(1):32-36
Publisher
Sociedade Portuguesa de Pediatria