Neonatal Birth Trauma: Analysis of Yearly Trends, Risk Factors, and Outcomes. J Pediatr 2021 Nov;238:174-180.e3
Date
07/10/2021Pubmed ID
34242670DOI
10.1016/j.jpeds.2021.06.080Scopus ID
2-s2.0-85110563276 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
OBJECTIVE: To evaluate the trends, proportions, risk factors, resource utilization, and outcomes of neonatal birth trauma in the US.
STUDY DESIGN: This cross-sectional study of in-hospital births used the Nationwide Inpatient Sample for 2006-2014. We divided the cases by type of birth trauma: scalp injuries and major birth trauma. Linear regression for yearly trends and logistic regression were used for risk factors and outcomes. A generalized linear model was used, with a Poisson distribution for the length of stay and a gamma distribution for total spending charges.
RESULTS: A total of 982 033 weighted records with neonatal birth trauma were found. The prevalence rate increased by 23% from (from 25.3 to 31.1 per 1000 hospital births). Scalp injuries composed 80% of all birth traumas and increased yearly from 19.87 to 26.46 per 1000 hospital births. Major birth trauma decreased from 5.44 to 4.67 per 1000 hospital births due to decreased clavicular fractures, brachial plexus injuries, and intracranial hemorrhage. There were significant differences in demographics and risk factors between the 2 groups. Compared with scalp injuries, major birth trauma was associated with higher odds of hypoxic-ischemic encephalopathy, seizures, need for mechanical ventilation, meconium aspiration, and sepsis. Length of stay was increased by 56%, and total charges were almost doubled for major birth trauma.
CONCLUSIONS: Neonatal birth trauma increased over the study period secondary to scalp injuries. Major birth trauma constitutes a significant health burden. Scalp injuries are also associated with increased morbidity and might be markers of brain injury in some cases.
Author List
Gupta R, Cabacungan ETAuthors
Erwin Cabacungan MD Associate Professor in the Pediatrics department at Medical College of WisconsinRuby Gupta MBBS Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Birth InjuriesCraniocerebral Trauma
Cross-Sectional Studies
Databases, Factual
Delivery, Obstetric
Female
Humans
Infant, Newborn
Male
Pregnancy
Retrospective Studies
Risk Factors
United States