Manske M Claire, Wilson Machelle D, Wise Barton L, Hedriana Herman L, Melnikow Joy, Tancredi Daniel J
Associate Professor, Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, USA.
Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, CA, USA.
J Perinatol. 2025 Mar 15. doi: 10.1038/s41372-025-02239-8.
To investigate the association of maternal race/ethnicity with risk factors for brachial plexus birth injury (BPBI) and quantify the proportion of excess BPBI risk due to these factors.
This retrospective cohort study of all livebirths occurring in California-licensed hospitals from 1996-2012 included 6,278,562 maternal-livebirth infant pairs with 7762 BPBI diagnoses. Multiple logistic regression and causal mediation analyses were used to evaluate the relationship of race/ethnicity and BPBI risk factors.
Black and Hispanic birthing-individuals were at increased risk of obesity, diabetes, and limited prenatal care utilization but decreased risk of many BPBI risk factors (shoulder dystocia, macrosomia, prolonged second stage of labor, and vaginal delivery).
Black and Hispanic birthing-individuals were at lower risk of many strongly associated risk factors for BPBI, and these factors mediate only a small proportion of their excess BPBI risk, underscoring the importance of identifying alternative risk factors, especially drivers of demographic disparities.
探讨母亲种族/族裔与臂丛神经产伤（BPBI）危险因素之间的关联，并量化这些因素导致的BPBI额外风险比例。
这项对1996年至2012年在加利福尼亚州持牌医院发生的所有活产进行的回顾性队列研究，纳入了6278562对母婴活产对，其中有7762例BPBI诊断。采用多因素逻辑回归和因果中介分析来评估种族/族裔与BPBI危险因素之间的关系。
黑人和西班牙裔分娩个体患肥胖症、糖尿病的风险增加，产前护理利用率有限，但许多BPBI危险因素（肩难产、巨大儿、第二产程延长和阴道分娩）的风险降低。
黑人和西班牙裔分娩个体患许多与BPBI密切相关的危险因素的风险较低，这些因素仅介导了他们额外BPBI风险的一小部分，这凸显了识别其他危险因素的重要性，尤其是人口统计学差异的驱动因素。
