Louden Emily, Marcotte Michael, Mehlman Charles, Lippert William, Huang Bin, Paulson Andrea
Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Good Samaritan Hospital, Department of Obstetrics and Gynecology, Division of Maternal/Fetal Medicine, Cincinnati, OH 45229, USA.
Children (Basel). 2018 Mar 29;5(4):46. doi: 10.3390/children5040046.
Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother's labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother's age >26.4 years, tachysystole, or fetal malpresentation) were present in any combination.
在过去几十年间，尽管医疗保健取得了进步，而这些进步似乎有助于降低臂丛神经产伤（BPBI）的发生率，但臂丛神经产伤的发生率却有所上升。本研究的目的是确定此前未知的臂丛神经产伤风险因素以及有可能指导预防措施的风险因素。对52名分娩出患有臂丛神经产伤婴儿的母亲和132名分娩出未患臂丛神经产伤婴儿的母亲进行了病例对照研究。单因素、多因素和逻辑回归分析确定了风险因素及其组合。使用催产素时，发生臂丛神经产伤的几率高出2.5倍，发生子宫收缩过速时则高出3.7倍。当母亲分娩期间出现子宫收缩过速和使用催产素时，臂丛神经产伤的几率会增加。逻辑回归分析表明，当以下变量中的任意三个以上（孕期体重增加超过30磅、第二产程超过61.5分钟、母亲年龄超过26.4岁、子宫收缩过速或胎位异常）同时出现时，臂丛神经产伤的风险更高。
