FRACTURE OF THE CLAVICLE IN THE NEWBORN FOLLOWING NORMAL LABOR AND DELIVERY

Citation
B. Kaplan et al., FRACTURE OF THE CLAVICLE IN THE NEWBORN FOLLOWING NORMAL LABOR AND DELIVERY, International journal of gynaecology and obstetrics, 63(1), 1998, pp. 15-20
Citations number
21
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
00207292
Volume
63
Issue
1
Year of publication
1998
Pages
15 - 20
Database
ISI
SICI code
0020-7292(1998)63:1<15:FOTCIT>2.0.ZU;2-W
Abstract
Objective: Earlier works have associated neonatal clavicular fracture (0.2-3.5% of all deliveries) with a range of procedural, fetal and mat ernal risk factors; more recent studies, however, have failed to firml y identify any one or a combination of them. In the present work we so ught to determine possible ante/intra-partum risk factors for this con dition. Study design: Using a retrospective case-controlled approach, we examined a series of maternal, fetal and pregnancy or delivery-rela ted variables in 87 cases (out of 403) of fractured clavicle of the ne wborn diagnosed in our department from 1986 to 1994. All infants were delivered vaginally (in the occipito-anterior position) at term by a s pecialist obstetrician and underwent peripartum sonographic fetal weig ht estimation. All variables were compared with those of an equal numb er of infants born immediately before or after each affected infant an d delivered by the same obstetrical team. Results: Fractured clavicles were found in 1.65% of the total number of deliveries during the stud y period. Neonatal clavicular fracture was significantly and directly related to the duration of the second stage of labor, peripartum sonog raphic fetal weight estimation, and neonatal length, and inversely rel ated to maternal height; nevertheless, all values in both the study an d control groups were within normal range. Logistic regression analysi s showed that these antenatal variables significantly affect the chanc es of clavicular fracture, but due to the high false-positive rate the y cannot serve clinically as a comprehensive antenatal prediction inde x. Conclusions: The majority of clavicular fractures occur in normal n ewborns following normal labor and delivery. The risk factors we ident ified statistically do not offer a method for clinical prenatal predic tion. This work provides statistical evidence of the nature of this co mplication of early newborn life. (C) 1998 International Federation of Gynecology and Obstetrics.