Peleg D, Hasnin J, Shalev E
Department of Obstetrics and Gynecology, Central Emek Hospital, Afula, Israel.
Am J Obstet Gynecol. 1997 Nov;177(5):1038-40. doi: 10.1016/s0002-9378(97)70010-3.
Our purpose was to determine the perinatal factors associated with clavicular fracture or Erb's palsy in neonates and to document the percentage of cases where no risk factors were involved.
We reviewed the medical records of all live-born singleton infants admitted to the newborn nurseries between 1992 and 1995. Mothers and infants with clavicular fracture or Erb's palsy were compared with those without these birth injuries.
Of 11,636 neonates, there were 236 (2.03%) with clavicular fracture and 51 (0.44%) with Erb's palsy. Clavicular fracture was significantly associated with shoulder dystocia and high birth weight. Significant factors associated with Erb's palsy were shoulder dystocia, high birth weight, prolonged second stage, instrumental delivery, fetal distress, use of oxytocin, and epidural anesthesia. A total of 51.7% of the neonates with clavicular fracture and 29.4% of those with Erb's palsy had none of the risk factors examined.
Although macrosomic fetuses and instrumental or difficult deliveries are risk factors for clavicular fracture and Erb's palsy, > 50% and 25%, respectively, occur without the risk factors examined.
我们的目的是确定与新生儿锁骨骨折或臂丛神经麻痹相关的围产期因素，并记录无危险因素的病例百分比。
我们回顾了1992年至1995年间入住新生儿病房的所有单胎活产婴儿的病历。将发生锁骨骨折或臂丛神经麻痹的母亲和婴儿与未发生这些出生损伤的进行比较。
在11636例新生儿中，有236例（2.03%）发生锁骨骨折，51例（0.44%）发生臂丛神经麻痹。锁骨骨折与肩难产和高出生体重显著相关。与臂丛神经麻痹相关的显著因素有肩难产、高出生体重、第二产程延长、器械助产、胎儿窘迫、使用缩宫素和硬膜外麻醉。共有51.7%的锁骨骨折新生儿和29.4%的臂丛神经麻痹新生儿没有所检查的危险因素。
尽管巨大胎儿以及器械助产或困难分娩是锁骨骨折和臂丛神经麻痹的危险因素，但分别有超过50%和25%的病例发生时没有所检查的危险因素。
