Neonatal Risk Factors for Obstetric Brachial Plexus Lesions [Article in Bosnian]

Aim – The aim of the study was to discover risk factors for delivery-plexus brachialis injury in newborns.  Methods – The data on plexus brachialis paralysis during the delivery of 45503 newborns were analyzed studying retrospectively babies who were delivered from 1 January 1996 to 31 December 2004 at Clin­ics for gynecology and obstetrics at the University-clinical centre in Tuzla. In the analyzed population we found 86 newborns with plexus brachialis injury which developed during delivery (examinees). The control group was formed of 86 newborns without plexus brachialis injury, chosen randomly as a sample from the same population (control group). The examinees and control group were compared regardless of gender, gestation period, delivery weight, presentation (occipital and pelvic) of the fetus during deliv­ery, as well as the Apgar score after the first and fifth minutes. The statistic significance of the results was evaluated with the I‡2 test.  Results – There were no differences in gender between the examinees and the control group. A signifi­cant difference in distribution of delivery weight was found between examinees and the control group: a frequency of delivery weight from 4000-4599 grams, and especially weight higher than 4500 grams, was significantly higher than in the control group. The discovered difference in incidence of occipital presentation during delivery in favor of the examinees was not statistically significant. Examinees had a significantly lower Apgar-score (≤7) - after both the first and fifth minutes. In 35 of 86 (42.5%) examinees we found combined clavicle fracture, plus in one humerus fracture and in one rib fracture.  Conclusion – The result of this research corresponds to findings from literature on risk factors for plexus brachialis injury: the most noticeable risk factors are delivery weight over 4000 grams and a low Apgar-score as a result of traumatic delivery, whereas in our research, contrary to other sources, the pelvic posi­tion of the foetus during delivery was not a statistically proven risk factor, at least in our case.