Birth Trauma in Newborns: Frequency, Associated Factors and Outcome at CHU Gabriel Touré Pediatric Department

Abstract

Introduction:Birth trauma in newborns is the result of difficult deliveries. Despite improvements in pregnancy monitoring and the standardization of delivery care, injuries in neonates during delivery remain a major concern in neonatology. Methodology: Study conducted from January 1, 2014 to December 31, 2018, was a retrospective, cross-sectional, analytical study. The purpose was to determine the frequency of obstetric trauma in newborns at CHU Gabriel TOURE, to analyze the different types of injuries observed and to assess risk factors. All newborns admitted to neonatology for injuries were included. Results: Thirty-nine neonates were included (n=39). The sex ratio was 1.29 (M= 22; F=17). Hospital frequency was 1.9 ‰. The majority of patients were admitted within the first 24h (n=35; 90%). The majority of mothers were aged between 20 and 34, (i.e.76.8 %). Multiparous women represented 38% of the mothers. No pregnancy follow-up had been carried out in 23.1% of mothers. Deliveries by vaginal route accounted for 82.1%. Caesarean section accounted for 18%. Transverse fetal presentation was the most frequent reason for Caesarean section, representing 57%. Instrumental delivery was performed in 23.1% of deliveries. Cupping was utilized in 18%. Perinatal anoxia accounted for 59% of newborns. Trauma in newborns was as follows: Serosanguineous bump (n= 6; 15%), Skull skin injury (n=5; 13%), Brachial plexus nerve palsy (n=13; 33%), Femur fracture (n=12; 31%). Trauma to the skull and face accounted for 25.6%. Twelve patients (31%) received treatment with a posterior splint. Twenty percent of neonates had polytraumatism. Instrumental birth was a significant factor in neonatal craniofacial trauma (p = 0.0001). Macrosomia was a risk factor for brachial plexus palsy (p= 0.03). Breech positioning was a factor in the occurrence of lower leg fractures (p=0.001). The mortality rate was 33.3% (n=13). Perinatal asphyxia was the main cause of death (n= 23; 59%). Conclusion: Newborn birth trauma remains a major concern in neonatology in our country. Enhanced monitoring of pregnancy and delivery will reduce the morbidity and mortality associated with this disorder.