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Labour characteristics and neonatal Erb’s palsy
Article first published online: 12 JUN 2007
DOI: 10.1111/j.1471-0528.2007.01392.x
RCOG 2007 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 8, pages 1003–1009, August 2007
Additional Information
How to Cite
Weizsaecker, K., Deaver, J. and Cohen, W. (2007), Labour characteristics and neonatal Erb’s palsy. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 1003–1009. doi: 10.1111/j.1471-0528.2007.01392.x
Publication History
- Issue published online: 12 JUN 2007
- Article first published online: 12 JUN 2007
- Accepted 10 April 2007. Published OnlineEarly 12 June 2007.
- Abstract
- Article
- References
- Cited By
Keywords:
- Brachial plexus injury;
- Erb’s palsy;
- labour
Objective To determine risk factors for Erb’s palsy, with a focus on graphic labour patterns.
Design A case–control study.
Setting New York City.
Sample A total of 45 consecutive cases of Erb’s palsy and 90 controls.
Methods Pregnancies and labours of neonatal Erb’s palsy cases were compared with 90 controls using univariate and multiple logistic regression analysis.
Main outcome measures Erb’s palsy and shoulder dystocia.
Results Mothers of children with Erb’s palsy had a higher term body mass index and more gestational diabetes than those of controls. Even cases without diabetes had higher blood glucose values after a 50-g glucose challenge than did controls. Cases had a higher birthweight and a lower ratio of head-to-thoracic circumference than controls. Shoulder dystocia occurred in 67% of cases and in 2% of controls (P= 0.001). Only 46% of labours had a completely normal dilatation pattern. In a multiple logistic regression model, variables independently associated with brachial plexus injury were long deceleration phase of labour, long second stage, high birthweight, black race, and high neonatal or maternal body mass.
Conclusions Erb’s palsy was frequently preceded by abnormal labour and shoulder dystocia; however, a substantial proportion of cases occurred after normal labour and delivery. Predictive models will be necessary to determine to what extent careful monitoring of the terminal portion of dilatation and of fetal descent and incorporation of maternal body mass and race (all independent risk factors in this study) will help identify fetuses at risk for brachial plexus palsy.