Obstetric brachial plexus injury: Risk factors and clinical follow-up results

Abstract

Obstetric brachial plexus injury is a significant cause of neonatal morbidity. The aim of this study was to evaluate the maternal and perinatal factors associated with plexus injury and to analyze clinical follow-up outcomes and parental caregiving burden. Material and Methods: This study was conducted as a retrospective descriptive study at the maternity center of a tertiary hospital. Deliveries resulting in obstetric plexus injury between February 2018 and December 2023 were included in the study. Out of 27,695 live births, 28 infants with plexus injury were identified and analyzed. Results: Of the women who gave birth to infants with brachial plexus injury, 25 (89.3%) were aged 21-34 years, and 22 (78.6%) had a body mass index between 25 and 29.99 kg/m2. Of the cohort, 16 (57.1%) were multiparous, and 3 (10.7%) had gestational diabetes. In addition, 15 (53.6%) women underwent labor induction, and all had vaginal deliveries. Shoulder dystocia occurred in 11 deliveries (39.3%). Of the newborns with brachial plexus injury, 25 (89.3%) had Erb's palsy. The mean follow-up period for the infants was 12 (3-31) months. Injury recovery occurred in 24 babies (85.7%), while four babies (14.3%) experienced permanent injury. Regarding parental caregiving burden, 22 parents (78.6%) reported "no to mild burden," while six parents (21.4%) reported a "mild to moderate burden." No parents reported "moderate to severe" or "severe burden". All newborns with permanent damage developed shoulder dystocia at delivery (p=0.007). Conclusion: Most infants with plexus injury recovered, while permanent injury was linked to shoulder dystocia, and parental caregiving burden was generally low. [J Turk Ger Gynecol Assoc. 2025; 26(3): 204-11]