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Shoulder dystocia and brachial plexus injury: a case-control study

Christoffersson, M; Kannisto, P; Rydhstroem, H; Stale, Håkan LU and Walles, B (2003) In Acta Obstetricia et Gynecologica Scandinavica 82(2). p.147-151
Abstract
Objective and Background. To evaluate risk factors for shoulder dystocia and brachial plexus injury using a case-control study at the departments of obstetrics and gynecology at the four largest hospitals in southern Sweden. All cases of shoulder dystocia between 1987 and 1993 inclusive were identified. For each case, two control infants with similar birthweight (+/- 100 g) and identical year of birth were randomly selected. Methods. Original maternal records were reviewed and information regarding 10 potential risk factors was extracted. Odds ratios (ORs) were calculated using the Mantel-Haenszel method. Stratification was made for year of delivery, parity (0, I, II, III+), and maternal age (5-year class). Results. In all, 107 infants... (More)
Objective and Background. To evaluate risk factors for shoulder dystocia and brachial plexus injury using a case-control study at the departments of obstetrics and gynecology at the four largest hospitals in southern Sweden. All cases of shoulder dystocia between 1987 and 1993 inclusive were identified. For each case, two control infants with similar birthweight (+/- 100 g) and identical year of birth were randomly selected. Methods. Original maternal records were reviewed and information regarding 10 potential risk factors was extracted. Odds ratios (ORs) were calculated using the Mantel-Haenszel method. Stratification was made for year of delivery, parity (0, I, II, III+), and maternal age (5-year class). Results. In all, 107 infants with shoulder dystocia and 198 controls were included. The OR was greater than unity for all risk factors except gestational age. Three of the risk factors, induction of labor, epidural analgesia, and instrumental delivery, reached statistical significance. Thirty-four infants also suffered brachial plexus injury, giving a brachial plexus injury rate of 32% among the shoulder dystocia cases. We also made a separate analysis of the nine risk factors for brachial plexus injury following a shoulder dystocia, however none reached statistical significance. Conclusion. In this case-control study based on more than 100 000 deliveries at four large hospitals during a 7-year period, induction of labor, epidural analgesia, and instrumental delivery turned out to be significant risk factors for shoulder dystocia. For brachial plexus injury following shoulder dystocia, no significant risk factor was identified. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
brachial plexus injury, shoulder dystocia, population
in
Acta Obstetricia et Gynecologica Scandinavica
volume
82
issue
2
pages
147 - 151
publisher
Wiley-Blackwell
external identifiers
  • wos:000181634200009
  • pmid:12648177
  • scopus:0037300998
ISSN
1600-0412
DOI
10.1034/j.1600-0412.2003.00079.x
language
English
LU publication?
yes
id
c39fb8a6-d46d-46c1-ae3c-22a5d2bb1afc (old id 900579)
date added to LUP
2008-01-10 18:48:48
date last changed
2017-01-01 06:37:07
@article{c39fb8a6-d46d-46c1-ae3c-22a5d2bb1afc,
  abstract     = {Objective and Background. To evaluate risk factors for shoulder dystocia and brachial plexus injury using a case-control study at the departments of obstetrics and gynecology at the four largest hospitals in southern Sweden. All cases of shoulder dystocia between 1987 and 1993 inclusive were identified. For each case, two control infants with similar birthweight (+/- 100 g) and identical year of birth were randomly selected. Methods. Original maternal records were reviewed and information regarding 10 potential risk factors was extracted. Odds ratios (ORs) were calculated using the Mantel-Haenszel method. Stratification was made for year of delivery, parity (0, I, II, III+), and maternal age (5-year class). Results. In all, 107 infants with shoulder dystocia and 198 controls were included. The OR was greater than unity for all risk factors except gestational age. Three of the risk factors, induction of labor, epidural analgesia, and instrumental delivery, reached statistical significance. Thirty-four infants also suffered brachial plexus injury, giving a brachial plexus injury rate of 32% among the shoulder dystocia cases. We also made a separate analysis of the nine risk factors for brachial plexus injury following a shoulder dystocia, however none reached statistical significance. Conclusion. In this case-control study based on more than 100 000 deliveries at four large hospitals during a 7-year period, induction of labor, epidural analgesia, and instrumental delivery turned out to be significant risk factors for shoulder dystocia. For brachial plexus injury following shoulder dystocia, no significant risk factor was identified.},
  author       = {Christoffersson, M and Kannisto, P and Rydhstroem, H and Stale, Håkan and Walles, B},
  issn         = {1600-0412},
  keyword      = {brachial plexus injury,shoulder dystocia,population},
  language     = {eng},
  number       = {2},
  pages        = {147--151},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Shoulder dystocia and brachial plexus injury: a case-control study},
  url          = {http://dx.doi.org/10.1034/j.1600-0412.2003.00079.x},
  volume       = {82},
  year         = {2003},
}