Prevalence and predisposing factors to birth fractures and brachial plexus injuries seen in a tertiary hospital in Calabar, Nigeria

INTRODUCTION: Birth injuries may occur even with the best standard of care, and even more in the presence of certain fetal, maternal and delivery related factors. In this study we sought to determine the prevalence of birth injuries and investigate the predisposing factors of birth fractures and nerve palsies. METHOD: This was a hospital-based Epidemiological study conducted between January 2014 – December 2016 and all patients with birth injuries were recruited into the study. Structured questionnaires were administered to parents or guardians after giving informed consent. Relevant data regarding maternal morbidity, birth weight, parity and mode of delivery was collected and analyzed using IBM SPSS version 22. Significant statistical inference was set at 0.05. Ethical approval was given by the institutional ethics and research committee. RESULTS: Forty-six patients were recruited into the study. Seventy six percent were referred within a week after birth. Male to female ratio was 1:1.1. Thirty-two (60.9%) had fractures while 14 (39.1%) had brachial plexus injuries. Twenty-seven(58.7%) were delivered by a midwife and one was delivered by a traditional birth attendant. Fourteen of the mothers (30.4%) were primipara while 13 were grandmultipara. Seventeen of the patients (37%) had a birth weight >4kg. Most mothers delivered in a secondary health facility (43.5%) while 5 (10.9%) delivered at home. Only 8 (17.4%) had cesarean section. Birth through cesarean section was significantly associated with lower risk of fractures and peripheral nerve palsy (p=0.04). CONCLUSION: Fractures were the commonest injury seen. Cesarean section had the lowest rate of birth fractures and nerve palsies