Department of Orthopaedic Surgery, Keck Medical Center at the University of Southern California.
Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
J Pediatr Orthop B. 2020 Jul;29(4):392-398. doi: 10.1097/BPB.0000000000000706.
Neonatal brachial plexus palsy (NBPP) is a birth injury that can cause severe functional loss in the affected limb. The purpose of this study was to determine the temporal changes in the national incidence of this condition and whether associated risk factors have changed over time. Children born via vaginal delivery were identified in the Kids' Inpatient Database (KID) from 1997 to 2012, and those with NBPP were identified. The trend in incidence and risk factors were assessed through the study period. The nationwide incidence of NBPP decreased during the study period. Infants with shoulder dystocia, fetal macrosomia, and gestational diabetes had the highest risk of developing NBPP, while multiple birth mates during delivery had a protective effect. Multiple risk factors, including shoulder dystocia, macrosomia, and heavy for dates became less predictive of the development of NBPP over time. Several risk factors predispose children to the development of NBPP, and the effect of these risk factors has been changing. This information can guide obstetric treatment to help prevent NBPP. Level of evidence is diagnostic, level 3.
新生儿臂丛神经麻痹（NBPP）是一种出生损伤，可导致受累肢体严重功能丧失。本研究旨在确定该疾病的全国发病率随时间的变化，以及相关的危险因素是否随时间发生变化。从 1997 年至 2012 年，通过 Kids' Inpatient Database（KID）确定了阴道分娩的儿童，并确定了患有 NBPP 的儿童。通过研究期间评估发病率和危险因素的趋势。在研究期间，NBPP 的全国发病率呈下降趋势。肩难产、胎儿巨大儿和妊娠期糖尿病的婴儿发生 NBPP 的风险最高，而分娩时多胎的婴儿则具有保护作用。随着时间的推移，包括肩难产、巨大儿和过期妊娠在内的多种危险因素对 NBPP 发展的预测作用降低。一些危险因素使儿童易患 NBPP，这些危险因素的作用一直在变化。这些信息可以指导产科治疗，帮助预防 NBPP。证据水平为诊断，3 级。
