Demographics and deprivation in obstetric brachial plexus palsy: a retrospective cohort study.

IF 2 2区 医学 Q2 ORTHOPEDICS Journal of Hand Surgery-European Volume Pub Date : 2024-05-01 Epub Date: 2023-09-11 DOI:10.1177/17531934231196421
Claire Madeline Hardie, Grainne Bourke, Emily Salt, Alice Fort-Schaale, Stephen Clark, Mikael Wiberg, Robert Bains
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Abstract

The present study analyses the relationships between deprivation and obstetric brachial plexus palsy (OBPP). A retrospective observational study was conducted of infants with OBPP seen between 2008 and 2020 (n = 321). The index of multiple deprivation (IMD) was used to assign an IMD rank to patients based on birth postcode and the relationship with OBPP was analysed, including deprivation, gestational diabetes, age at referral and at first assessment. Quintile-based analysis demonstrated over-representation of patients from more deprived neighbourhoods (n = 109, 39%) living in the top 20% most deprived neighbourhoods. A total of 48 (15%) mothers had diabetes and 98 (31%) infants underwent surgical brachial plexus exploration (a marker of disease severity). Neither diabetes, age at referral nor age at first assessment were associated with IMD score. This suggests that neighbourhood deprivation is associated with OBPP, though the mechanisms are unclear. Further studies in this area may enable targeted health intervention for more deprived maternal and infant groups.Level of evidence: III.

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产科臂丛神经麻痹的人口统计学和贫困状况:一项回顾性队列研究。
本研究分析了贫困与产科臂丛神经麻痹(OBPP)之间的关系。本研究对 2008 年至 2020 年间就诊的 OBPP 婴儿(n = 321)进行了回顾性观察研究。研究采用多重贫困指数(IMD),根据出生地邮政编码为患者划分IMD等级,并分析其与OBPP的关系,包括贫困程度、妊娠糖尿病、转诊年龄和首次评估年龄。基于五分位数的分析表明,居住在前 20% 最贫困社区的患者中,来自更贫困社区的患者人数过多(109 人,占 39%)。共有 48 名(15%)母亲患有糖尿病,98 名(31%)婴儿接受了臂丛神经探查手术(疾病严重程度的标志)。糖尿病、转诊年龄和首次评估年龄均与 IMD 评分无关。这表明,邻里贫困与 OBPP 相关,但其机制尚不清楚。对这一领域的进一步研究可为更贫困的孕产妇和婴儿群体提供有针对性的健康干预:证据等级:III。
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来源期刊
CiteScore
3.10
自引率
16.70%
发文量
190
审稿时长
4-8 weeks
期刊介绍: The Journal of Hand Surgery (European Volume) is essential reading for everyone involved in restoring the function to the hand and upper limb. Dedicated to the needs of hand, plastic, reconstructive and orthopaedic surgeons, it publishes the best selection of current papers on hand surgery. The journal regularly highlights key developments in a range of original, authoritative and highly informative articles written by distinguished experts from around the world. Rapid coverage of the latest research, techniques, trends and ideas to make sure you stay up-to-date. Subjects covered include: joint replacement fracture and joint injuries microvascular surgery congenital hand problems You will also find editorials, book reviews, conference dates, case studies, detailed coverage of new techniques and full-length reviews articles.
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