A Clinical Study of Neonatal Birth Injuries in a Tertiary Care Hospital-Nicu, Bijapur

Abstract

B irth injuries or birth trauma is defined as impairment or injury suffered by the neonate during delivery or during the entire birth process [1]. The predisposing risk factors for birth injuries can be classified into maternal, fetal, or birth attendants associated. The common risk factors of birth injuries are usually identified early in pregnancy or at an early stage of labor by trained health professionals, however, either due to lack of experience or poor facility setting, newborn incur a severe form of birth injury. The common risk factors for birth injuries are lack of supervision of pregnancy, maternal medical conditions, difficult labor, short or prolonged labor, obstructed labor, higher birth weight >4000 g, instrumental delivery, malpresentation, and maternal age <16 years or >35 years [2-5]. Injury may occur during labor, delivery, or after delivery, especially in neonates who require resuscitation in the delivery room. It can occur during both vaginal and cesarean deliveries [6]. Varied incidence has been reported in literature. It may be associated with increased morbidity and mortality [7]. There is a wide spectrum of birth injuries ranging from minor and self-limited problems (e.g., laceration or bruising) to severe injuries that may ABSTRACT Background: Neonatal birth injuries are the third major cause of neonatal mortality in most developing countries. Very few studies have been done in India on birth injuries and its relation to various factors such as undesirable presentations and parity. Aim: The present study was conducted to analyze the birth injuries in our setup to know the various perinatal circumstances leading to birth injuries. Materials and Methods: An observational study was done in which 100 cases of birth trauma were noticed among 850 consecutive viable births during the study period of 2 years. Details of the health status of the mother, antenatal, intra-natal, and postnatal particulars, including the age, sex, weight, mode of delivery, type of presentation, and nature of the birth injury in different modes of delivery and type of presentation of the baby were taken. Results: It was found that of 850 newborn babies, 100 babies were found to have birth injuries, thus giving an incidence of 11.76% per 100 live births. Asphyxia formed the major groups which were noted in 45 babies. Cephalohematoma was the next common injury being noted in 32 cases. A total of 18 babies had soft tissue injuries and 4 babies had neurological injuries. Conclusion: Our findings support to use data on neonatal birth injuries as an indicator to assess the quality and safety of maternity units.

Prevalence of birth injuries and associated factors among newborns delivered in public hospitals Addis Ababa, Ethiopia, 2021. Crossectional study

“…Those neonates born via instrumental assisted were 10.6 times (AOR = 10.6, 95% CI: 3.45–32.7) more susceptible to experience birth trauma than neonates delivered via cesarean section. This finding was in agreement with studies conducted in Bombay Hospital [ 26 ], Indian [ 13 ] and Nigeria [ 12 ]. The likely reason was due to the fact that, application of forceps and vacuum on the fetal head may expose to extra cranial hemorrhage, intra cranial hemorrhage and soft tissue abrasion/laceration.…”

“…In this study the prevalence of birth asphyxia was 13.9% with 95% CI (10.5–17.7). This finding was higher compared to studies conducted in Jimma 8.1% [ 18 ], Dire Dawa 2.5% [ 20 ] and South Indian 5.29% [ 13 ]. However, it was lower than the studies conducted in Jimma zone public hospitals 32.9% [ 19 ], Debre Tabor 28.35% [ 22 ], North East Amhara 22.6% [ 21 ] and Hossana 15.1% [ 8 ].…”

“…The overall prevalence of birth injury among live birth newborns was 24.7% with 95% CI (20.1–29.0). It was higher than studies conducted in Indian, Iran, Nigeria and Jimma (11.76%, 2.2%, 5.7%, 15.4% respectively) [ 10 , 12 , 13 , 18 ]. This variation might be due to difference in sample size and study area (this study conducted in referral hospitals where more complicated cases and referred from different setting that could increase the prevalence of birth injury in the study area).…”

“…According to international classification of disease 10 th revision (ICD-10) and different literature, the common types of birth injuries includes birth asphyxia and birth trauma (soft tissue injuries (bruises, petechial, subcutaneous fat necrosis, ulceration and perforation), extra cranial hemorrhages (cephalhaematoma, caput succedaneum, subgalial hemorrhage), intra-cranial hemorrhages, neurological injury (spinal cord injury, facial nerve palsy, brachial plexus injury such as Erb’s palsy and Klumpke’s palsy), musculoskeletal injury (long bone and clavicular fracture) [ 10 – 13 ].…”

Incidence, contributing factors and outcomes of birth injury among newborns in Africa: a systematic review of quantitative evidence protocol

“…However, some birth injuries can be serious and require ongoing medical care. [4][5][6][7] Globally, an estimated 2.5 million newborns die each year from birth trauma. This accounts for 46% of all deaths in children under the age of 5.…”