Identification of pregnancies at increased risk of brachial plexus birth palsy – the construction of a weighted risk score

Lindqvist, Pelle G.; Ajne, Gunilla; Cooray, Charith; Erichs, Kristina; Gudmundsson, Sæmundur; Dahlin, Lars B.

doi:10.3109/14767058.2013.809415

Cited by 8 publications

(12 citation statements)

References 11 publications

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“…The risk of Erb's palsy has been studied previously with contradictory results. There are studies reporting no increased risks of Erb's palsy in offspring of women with GDM . In a previous Swedish study, the risk of Erb's palsy was more than doubled in offspring of women with GDM, even after taking maternal BMI into account .…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

et al. 2019

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Aims To evaluate the interaction effects of gestational diabetes ( GDM ) with obesity on perinatal outcomes. Methods A population‐based cohort study in Sweden excluding women without pre‐gestational diabetes with a singleton birth between 1998 and 2012. Logistic regression was performed to evaluate the potential independent associations of GDM and BMI with adverse perinatal outcomes as well as their interactions. Main outcome measures were malformations, stillbirths, perinatal mortality, low Apgar score, fetal distress, prematurity and Erb's palsy. Results Some 1,294,006 women were included, with a GDM prevalence of 1% ( n = 14,833). The rate of overweight/obesity was 67.7% in the GDM ‐group and 36.1% in the non‐ GDM ‐group. No significant interaction existed. Offspring of women with GDM had significantly increased risk of malformations, adjusted odds ratio ( aOR ) 1.16 (95% confidence intervals 1.06–1.26), prematurity, aOR 1.86 (1.76–1. 98), low Apgar score, aOR 1.36 (1.10–1.70), fetal distress, aOR 1.09 (1.02–1.16) and Erb's palsy aOR 2.26 (1.79–2.86). No risk for stillbirth or perinatal mortality was seen. Offspring of overweight ( BMI 25–29.9 kg/m 2 ), obese ( BMI 30–34.9 kg/m 2 ) and severely obese women ( BMI ≥ 35.0 kg/m 2 ) had significantly increased risks of all outcomes including stillbirth 1.51 (1.40–1.62) to 2.85 (2.52–3.22) and perinatal mortality 1.49 (1.40–1.59) to 2.83 (2.54–3.15). Conclusions There is no interaction effect between GDM and BMI for the studied outcomes. Higher BMI and GDM are major independent risk factors for most serious adverse perinatal outcomes. More effective pre‐pregnancy and antenatal interventions are required to prevent serious adverse pregnancy outcomes among women with either GDM or high BMI .

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Section: Discussionmentioning

confidence: 99%

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

et al. 2019

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“…We also aimed at identifying variables that could be a common cause of both BPBI and psychotropic drug use and, thereby, confound the association between BPBI and psychotropic drug use. For this purpose, we first considered variables which, based on previous findings, are associated with increased risk for BPBI [ 12 – 15 , 17 ]. Thereafter, we considered these variables’ potential association with psychotropic drug use in adolescence, thereby distinguishing between variables used in interaction analyses and potential confounders.…”

Section: Methodsmentioning

confidence: 99%

“…Gestational age was included as it may possibly increase the risk for both BPBI [ 13 , 17 ] and impaired mental health [ 42 – 43 ]. Therefore, we defined gestational categories (a) <28 weeks, (b) 28–37 weeks, (c) 37–40 weeks, (d) 40–42 weeks and (e) >42 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Prognosis for C5-C6 (C7) BPBI is significantly better, with about 80–90% of children regaining function [ 13 ]. However, as it is not possible to predict, in the single case [ 17 ], the consequences of an injury [ 13 , 16 ], parents are commonly informed that their child may develop neurological disability of unpredictable degree. Combined with the fact that the child seemed entirely healthy until birth, but unexpectedly suffered a disabling injury at birth, this unpredictability and the necessary wait for a more accurate prognosis [ 17 ], may be additional stressors for parents [ 18 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, as it is not possible to predict, in the single case [ 17 ], the consequences of an injury [ 13 , 16 ], parents are commonly informed that their child may develop neurological disability of unpredictable degree. Combined with the fact that the child seemed entirely healthy until birth, but unexpectedly suffered a disabling injury at birth, this unpredictability and the necessary wait for a more accurate prognosis [ 17 ], may be additional stressors for parents [ 18 – 19 ]. It is therefore not surprising that BPBI diagnosis is often linked with parental dissatisfaction concerning both the birth and consequent contacts with the healthcare system [ 10 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Psychotropic drug use as indicator of mental health in adolescents affected by a plexus injury at birth: A large population-based study in Sweden

et al. 2018

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Chronic handicap in early life may have a long-term impact on children’s psychosocial well-being. Here, we investigated whether Brachialis Plexus Birth Injury (BPBI)—an unpredictable injury at birth—is associated with worse mental health later on, as indicated by prescription and use of psychotropic drugs in adolescence. We explored further whether this association is different depending on socioeconomic characteristics of the child’s family, as well as sex. Of the 641 151 children born to native parents in Sweden 1987–1993 (alive and still living in Sweden at the end of 2008), identified in the Swedish Medical Birth Registry, 1587 had suffered a BPBI. Logistic regression analysis was performed to assess the impact of socioeconomic characteristics and associations with later psychosocial health. Results show that beyond the known increased risks for females as compared to males, BPBI, but also lower family income, further increased the risk of burdened mental health requiring psychotropic drug use in adolescence. The effects were additive. Thus, compared to unaffected peers, teenagers who suffered a BPBI at birth are at higher risk of suffering poor mental health during adolescence, independently of surgical intervention and its outcome. Girls growing up in families with lower socioeconomic status have this risk added to their already increased risk of poor mental health during adolescence.

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Antenatal awareness and obstetric outcomes in large fetuses: A retrospective evaluation

Dodd

Lindqvist

2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Identification of pregnancies at increased risk of brachial plexus birth palsy – the construction of a weighted risk score

Abstract: Our findings indicate that it is possible to identify women at increased risk of having a child with BPBP by using variables observable in advance of delivery.

Cited by 8 publications

References 11 publications

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

Psychotropic drug use as indicator of mental health in adolescents affected by a plexus injury at birth: A large population-based study in Sweden

Antenatal awareness and obstetric outcomes in large fetuses: A retrospective evaluation

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