McFarland L V, Raskin M, Daling J R, Benedetti T J
Obstet Gynecol. 1986 Dec;68(6):784-8.
Methods of delivery, maternal and neonatal characteristics were examined to determine their role in the occurrence of Erb/Duchenne's palsy. Data from 210,947 Washington state birth certificates from 1980 through 1982 were examined. The incidence was 50.2 cases of Erb's palsy per 100,000 live births. A case control study design was used to analyze 106 cases and 386 controls by both univariable and multivariable analysis. Birth weight was shown to be a significant risk factor regardless of which method of delivery was used. A high birth weight infant (4001-4500 g) had 2.5 times the risk of incurring an upper brachial plexus injury compared with normal size infants (2501-4000 g). The risk for infants greater than 4500 g increased another tenfold (OR = 21.0). When birth weight was controlled for in the analysis, midforceps (OR = 18.3), vacuum extraction (OR = 17.2), and low forceps (OR = 3.7) remained significantly associated with the Erb's palsy. Delivery by cesarean section was associated with a significant protective effect (OR = 0.5) compared with instrumental vaginal delivery. These data demonstrate a high risk for serious birth injury associated with instrumental midpelvic delivery.
研究了分娩方式、母婴特征，以确定它们在臂丛神经麻痹/杜兴氏麻痹发生中的作用。研究了1980年至1982年华盛顿州210,947份出生证明的数据。每10万例活产中臂丛神经麻痹的发病率为50.2例。采用病例对照研究设计，通过单变量和多变量分析对106例病例和386例对照进行分析。无论采用何种分娩方式，出生体重均被证明是一个重要的危险因素。与正常体重婴儿（2501 - 4000克）相比，高出生体重婴儿（4001 - 4500克）发生上臂丛神经损伤的风险是其2.5倍。体重超过4500克的婴儿风险增加了另外10倍（比值比 = 21.0）。在分析中控制出生体重后，中位产钳（比值比 = 18.3）、真空吸引（比值比 = 17.2）和低位产钳（比值比 = 3.7）仍与臂丛神经麻痹显著相关。与器械助产阴道分娩相比，剖宫产具有显著的保护作用（比值比 = 0.5）。这些数据表明，骨盆中部器械助产与严重产伤的高风险相关。
