Newly Identified Preventable Risk Factors for Neonatal Clavicle Fractures

Abstract

Objective: Despite its excellent prognosis, neonatal clavicular fracture often leads to complaints regarding the proficiency of the delivery process and increased obstetrician frustration. It is considered an unavoidable complication of birth because most risk factors are uncontrollable. This retrospective study aimed to determine the obstetric and neonatal characteristics associated with neonatal clavicular fracture at our institution. Methods: The data that obtained from the medical records of newborns delivered by spontaneous vaginal delivery and clinically diagnosed with clavicular fracture along with an x-ray confirmation were retrospectively evaluated. For each infant with a clavicular fracture, a healthy infant delivered by the same obstetrical team was enrolled as the control. Fetal, maternal, and delivery factors were evaluated in the fracture and control groups. Results: Among the 106 newborn clavicle fracture cases, only 75 met the inclusion criteria and were enrolled in this study. Following the inclusion criteria, 75 healthy newborns were enrolled as controls. Birth weight and fetal distress were identified as fetal risk factors. Smoking during pregnancy, maternal hypothyroidism, and complications during pregnancy were maternal risk factors. Epidural anesthesia and instrumental delivery were identified as delivery risk factors Conclusion: Smoking during pregnancy, maternal hypothyroidism, and epidural anesthesia have not been identified as risk factors for neonatal clavicle fracture. The risk factors that are mostly mentioned are uncontrollable. However, smoking and epidural anesthesia are risk factors that can be prevented.