Leeds Institute for Medical Research, University of Leeds, Leeds, UK.
Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals Trust, Leeds, UK.
J Hand Surg Eur Vol. 2024 May;49(5):570-575. doi: 10.1177/17531934231196421. Epub 2023 Sep 11.
The present study analyses the relationships between deprivation and obstetric brachial plexus palsy (OBPP). A retrospective observational study was conducted of infants with OBPP seen between 2008 and 2020 ( = 321). The index of multiple deprivation (IMD) was used to assign an IMD rank to patients based on birth postcode and the relationship with OBPP was analysed, including deprivation, gestational diabetes, age at referral and at first assessment. Quintile-based analysis demonstrated over-representation of patients from more deprived neighbourhoods ( = 109, 39%) living in the top 20% most deprived neighbourhoods. A total of 48 (15%) mothers had diabetes and 98 (31%) infants underwent surgical brachial plexus exploration (a marker of disease severity). Neither diabetes, age at referral nor age at first assessment were associated with IMD score. This suggests that neighbourhood deprivation is associated with OBPP, though the mechanisms are unclear. Further studies in this area may enable targeted health intervention for more deprived maternal and infant groups. III.
本研究分析了剥夺与产伤性臂丛神经麻痹(OBPP)之间的关系。对 2008 年至 2020 年期间就诊的 OBPP 婴儿(n=321)进行了回顾性观察性研究。根据出生时的邮政编码,使用多因素剥夺指数(IMD)为患者分配 IMD 等级,并分析与 OBPP 的关系,包括剥夺程度、妊娠期糖尿病、转诊时的年龄和首次评估时的年龄。五分位数分析表明,来自贫困程度更高的社区(n=109,39%)的患者更多地居住在最贫困的前 20%的社区。共有 48 名(15%)母亲患有糖尿病,98 名(31%)婴儿接受了手术性臂丛神经探查(疾病严重程度的标志)。糖尿病、转诊时的年龄和首次评估时的年龄均与 IMD 评分无关。这表明,社区剥夺与 OBPP 有关,但机制尚不清楚。在这一领域的进一步研究可能会为贫困程度较高的母婴群体提供有针对性的健康干预措施。III.