Risk factors for obstetrical brachial plexus palsy

Objective: The study was aimed to identify the risk factors for obstetrical brachial plexus palsy (OBPP). Patients and Methods: A retrospective case–control study was designed. A comparison was performed between cases of brachial plexus paralysis (n = 32), with controls without brachial plexus paralysis (n = 30) randomly selected from physical rehabilitation medicine examination. Statistical analysis was performed using the SPSS Package. Results: Independent risk factors for brachial plexus paralysis were macrosomia (birth weight 4000 g; odds ratio [OR] = 12.353; 95% confidence interval [CI] 2.510–60.802, P < 10−3), labor dystocia and instrumental vaginal delivery (forceps delivery and vacuum extraction; OR = 8.8; 95% CI 2.743–28.234, P < 10−3), and prolonged pregnancy (OR = 1.28; 95% CI 1.066–1.538, P = 0.011); however, vaginal breech delivery (breech presentation or extraction; OR = 3.231; 95% CI 0.598–17.456, P = 0.258), parity (OR = 2.545; 95% CI 0.677–9.565, P = 0.206), shoulder dystocia (OR = 1.957; 95% CI 0.571–6.702, P = 0.367), and after cesarean section (OR = 1.103; 95% CI 0.987–1.234, P = 0.238) do not represent any risk factor. Conclusions: In our population (n = 62), macrosomia, labor dystocia, instrumental vaginal delivery, and prolonged pregnancy were the significant risk factors for neonatal brachial plexus paralysis, while shoulder dystocia, breech deliveries, parity, and cesarean section were not. Despite our small sample, we found three significant risk factors associated with OBPP.