Obstetric brachial plexus injury: risk factors related to recovery

Objective: To investigate if multivariate risk calculation can discriminate those infants who do not recover after an obstetric brachial plexus injury (OBPI). Study design: All liveborn infants without lethal congenital abnor malities from 1988 through 1996 with a gestational age greater than or equa l to 30 weeks were included. Outcome variables were all OBPI and non-recove red OBPI. Risk calculation was performed by univariate analysis for all inf ants and by multivariate logistic analysis for all singleton infants delive red vaginally in cephalic presentation. Results: A total of 62 of 13 366 li veborn infants sustained an OBPI (0.46%). Seventeen (27%) did not recover c ompletely. Birth weight, female sex, second stage >60 min, diabetes, multip arity, maternal age and non-Caucasian origin were important risk factors fo r non-recovered OBPI. A model without birth weight, which can not be measur ed accurately antepartum, is considerably less effective. Risk factors for all OBPI and for non-recovered OBPI were similar. Conclusion: A predictive multivariate model is of limited value due to the low incidence of non-reco vered OBPI. However, it may be useful to discriminate individual cases with exceptional risk. (C) 2000 Elsevier Science Ireland Ltd. All rights reserv ed.