Neonatal birth trauma: incidence and predisposing factors
Keywords:
birth trauma, cesarean section, forceps extraction, vacuum extraction
Abstract
Background The incidence of birth trauma and its predisposingfactors at a major teaching hospital in Indonesia had not been reported.
Objective To find the incidence of birth trauma, calculate a risk
assessment of predisposing factors, to study whether cesarean
section lowers birth trauma, and to identify the variety of morbidity
and mortality due to birth trauma.
Methods The incidence was studied retrospectively from 4843
medical records from January 2000 through June 2001 using the
ICD-10 classification. Birth trauma cases were then included in a
case-control study for a risk assessment profile of predisposing
factors with logistic regression analysis.
Results Three hundreds and thirty five out of 4843 neonates were
identified to have birth trauma. Analysis revealed that forceps
extraction (OR=48.29; p<0.01), vacuum extraction (OR=25.37;
p<0.01), breech vaginal delivery (OR=3.94; p=0.03), and cesarean
section (OR=3.44; p<0.01) were significant risk factors.
Macrosomic infant (OR=3.86; p=0.04) was also significant. Birth
injury to face (ICD-10 code P15.4) was the most common finding,
followed by cephalhematoma and bruising of the scalp.
There was no mortality due to birth trauma.
Conclusions The incidence of birth trauma was still high. Cesarean
section was found to be one of the risk factors, but
compared to forceps and vacuum extraction, the risk of trauma
is considered to be more acceptable.
References
1. Luthi JC, Dolan MS, Ballard DJ. Evidence-based
healthcare quality management in obstetrics and gynecology.
Clin Obstet Gynecol 1998;41:348-58.
2. Gresham EL. Birth trauma. Pediatr Clin North Am
1975;22:317-27.
3. Kadri N. Trauma lahir. In: Markum AH, Ismael S,
Alatas H, editors. Buku ajar ilmu kesehatan anak. 1st
ed. Jakarta: Fakultas Kedokteran Universitas Indonesia;
1991. p. 265-79.
4. Mangurten HH. Birth Injuries. In: Fanaroff AA, Martin
RJ, editors. Neonatal-perinatal medicine. Disease
of the fetus and infant. 6th ed. St. Louis: Mosby; 1997.
p. 425-54.
5. Laoria N, Itani O. Birth trauma. eMedicine Journal
2001;2:1–10
6. Towner D, Castro MA, Eby-Wilkens E, Gilbert W.
Effect of mode of delivery in nulliparous women on
neonatal intracranial injury. N Eng J Med
1999;341:1709-14.
7. Rubin A. Birth injuries: incidence, mechanisms, and
end results. Obstet Gynecol 1964;23:218-21.
8. Wegman ME. Annual summary of vital statistic 1981.
Pediatrics 1982;70:835.
9. Wegman ME. Annual summary of vital statistic 1984.
Pediatrics 1985;76:861.
10. Wegman ME. Annual summary of vital statistic 1993.
Pediatrics 1994;94:792.
11. Kliegman RM. The fetus and the neonatal infant. In:
Behrman RE, Kliegman RM, Arvin AM, editors.
Nelson textbook of pediatrics. 15th ed. Philadelphia:
W.B. Saunders Co; 1996. p. 465-71.
12. Wiknjosastro H. Fisiologi dan mekanisme persalinan
normal. In: Wiknjosastro H, Sumapradja S, Saifuddin
AB, editors. Ilmu kebidanan. 2nd ed. Jakarta: Yayasan
Bina Pustaka Sarwono Prawirohardjo; 1986. p. 146-57.
13. Hughes CA, Harley EH, Milmoe G, Bala R, Martorella
A. Birth trauma in the head and neck. Arch
Otolaryngol Head Neck Surg 1999;125:193-9.
14. Levine MG, Holroyde J, Woods JR, Siddiqi TA, Scott
M, Miodovnik M. Birth trauma: incidence and predisposing
factors. Obstet Gynecol 1994;63:6:792-5.
15. McFarland LV, Raskin M, Daling JR Benedetti TJ. Erb/
Duchenne’s palsy: a consequence of fetal macrosomia
and method of delivery. Obstet Gynecol 1986;
68:784-8.
16. Kolderup LB, Laros RK, Musci TJ. Incidence of persistent
birth injury in macrosomic infants: association
with mode of delivery. Am J Obstet Gynecol
1997;177: 37-41.
17. Beall MH, Spong C, McKay J, Ross MG. Objective
definition of shoulder dystocia: a prospective evaluation.
Am J Obstet Gynecol 1998;179:934-7.
18. Johanson R, Pusey J, Livera N, Jones P. North Staffordshire/
Wigan- assisted delivery trial. Br J Obstet Gynecol
1989;96:537.
19. Croughan-Minihane MS, Petitti DB, Gordis L,
Golditch I. Morbidity among breech infants according
to method of delivery. Obstet gynecol
1990;75:821-5.
20. Notzon FC. International differences in the use of obstetric
intervention. JAMA 1990;263:3286-91.
healthcare quality management in obstetrics and gynecology.
Clin Obstet Gynecol 1998;41:348-58.
2. Gresham EL. Birth trauma. Pediatr Clin North Am
1975;22:317-27.
3. Kadri N. Trauma lahir. In: Markum AH, Ismael S,
Alatas H, editors. Buku ajar ilmu kesehatan anak. 1st
ed. Jakarta: Fakultas Kedokteran Universitas Indonesia;
1991. p. 265-79.
4. Mangurten HH. Birth Injuries. In: Fanaroff AA, Martin
RJ, editors. Neonatal-perinatal medicine. Disease
of the fetus and infant. 6th ed. St. Louis: Mosby; 1997.
p. 425-54.
5. Laoria N, Itani O. Birth trauma. eMedicine Journal
2001;2:1–10
6. Towner D, Castro MA, Eby-Wilkens E, Gilbert W.
Effect of mode of delivery in nulliparous women on
neonatal intracranial injury. N Eng J Med
1999;341:1709-14.
7. Rubin A. Birth injuries: incidence, mechanisms, and
end results. Obstet Gynecol 1964;23:218-21.
8. Wegman ME. Annual summary of vital statistic 1981.
Pediatrics 1982;70:835.
9. Wegman ME. Annual summary of vital statistic 1984.
Pediatrics 1985;76:861.
10. Wegman ME. Annual summary of vital statistic 1993.
Pediatrics 1994;94:792.
11. Kliegman RM. The fetus and the neonatal infant. In:
Behrman RE, Kliegman RM, Arvin AM, editors.
Nelson textbook of pediatrics. 15th ed. Philadelphia:
W.B. Saunders Co; 1996. p. 465-71.
12. Wiknjosastro H. Fisiologi dan mekanisme persalinan
normal. In: Wiknjosastro H, Sumapradja S, Saifuddin
AB, editors. Ilmu kebidanan. 2nd ed. Jakarta: Yayasan
Bina Pustaka Sarwono Prawirohardjo; 1986. p. 146-57.
13. Hughes CA, Harley EH, Milmoe G, Bala R, Martorella
A. Birth trauma in the head and neck. Arch
Otolaryngol Head Neck Surg 1999;125:193-9.
14. Levine MG, Holroyde J, Woods JR, Siddiqi TA, Scott
M, Miodovnik M. Birth trauma: incidence and predisposing
factors. Obstet Gynecol 1994;63:6:792-5.
15. McFarland LV, Raskin M, Daling JR Benedetti TJ. Erb/
Duchenne’s palsy: a consequence of fetal macrosomia
and method of delivery. Obstet Gynecol 1986;
68:784-8.
16. Kolderup LB, Laros RK, Musci TJ. Incidence of persistent
birth injury in macrosomic infants: association
with mode of delivery. Am J Obstet Gynecol
1997;177: 37-41.
17. Beall MH, Spong C, McKay J, Ross MG. Objective
definition of shoulder dystocia: a prospective evaluation.
Am J Obstet Gynecol 1998;179:934-7.
18. Johanson R, Pusey J, Livera N, Jones P. North Staffordshire/
Wigan- assisted delivery trial. Br J Obstet Gynecol
1989;96:537.
19. Croughan-Minihane MS, Petitti DB, Gordis L,
Golditch I. Morbidity among breech infants according
to method of delivery. Obstet gynecol
1990;75:821-5.
20. Notzon FC. International differences in the use of obstetric
intervention. JAMA 1990;263:3286-91.
Published
2016-10-10
How to Cite
1.
Aminullah A, Budiwardhana N, Firmansyah A. Neonatal birth trauma: incidence and predisposing factors. PI [Internet]. 10Oct.2016 [cited 23Dec.2024];43(6):220-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/839
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Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-10
Accepted 2016-10-10
Published 2016-10-10
