Birth injuries in newborn: A prospective study of deliveries in South-East Nigeria

Abstract

Birth injury is an important cause of short and long-term deformity and disability in children. It is becoming an increasing source of litigation in developing countries. Exploring the magnitude of the problem in a resource-limited setting, and, identifying associated factors, will help reduce its occurrence. This surveillance for birth injuries is a 4-year prospective study conducted in the Enugu State University Teaching Hospital (ESUTH) between 2013 and 2017. Newborns with birth injuries and controls delivered around the same time with similar clinic-anthropometric parameters were enrolled for this study. One thousand nine hundred and twenty newborns were seen during the study period. Forty-six birth injuries were recorded giving in-hospital incidence rate of 24.0 (CI 17.3-30.9) per 1000 live birth. Majority (64.1%) of the injuries seen were related to the scalp. The commonest birth injuries encountered included Caput Succedaneum (41.2), Cephalohematoma (22.9), Erb’s Palsy (17.4), and shoulder dislocation (6.5). One case fatality (2.5%) due to skull fracture secondary to forceps delivery was noted. Birth weight (P=0.034), perinatal asphyxia (P=0.001) and prolonged labour (P=0.001) were significantly associated with birth injuries in the newborns surveyed. Birth injury remains a common and serious medical issue in our setting. Being proactive during antenatal care and labour could go a long way in minimizing the incidence of birth injuries and its consequences on children especially in the presence of risk factors such as high birth weight, perinatal asphyxia and prolonged labour. Key words: Birth injuries, newborns, delivery, Enugu.