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.