Profile of Birth Injuries in a Tertiary Hospital in Enugu, Nigeria

Abstract

Background: Birth injury is defined as structural damage of a newborn secondary to mechanical forces that occur during labor and/or delivery. This study determined the incidence, risk factors and outcome of birth injury. Methodology: This was an observational study of birth injuries in neonates, over a period of one year, carried out at a tertiary hospital in Enugu, south east, Nigeria. Results: Out of the 1,735 births recorded during the period of the study, there were 19 cases of birth injuries. This gave an incidence of 11 per 1000 live births. No neonate had more than one injury. They were thirteen males and six females that sustained birth injury. Cephalohematoma was the most common birth injury. Others are caput succedaneum, clavicular fracture, Erb's palsy, femoral fracture, humeral fracture, shoulder dislocation and facial laceration. Mode of delivery, neonatal birth weight, gestational age and maternal parity were significant predictive risk factors for birth injury. Conclusion: In the current study, cephalohematoma was the most common birth injury, followed by caput succedaneum. There is need to reduce the morbidity and mortality associated with birth injuries.

Incidence, Pattern and Outcome of Birth Injuries as Seen in a Tertiary Hospital in Southern Nigeria

“…There was male preponderance in the present study which was in conformity with several studies in Nigeria [4,5,[16][17][18] and India. [11,19] In contrast, Ray et al [20] and Pinto et al [21] reported female preponderance.…”

“…More than half (51.3%) of the neonates with birth injuries in the present study were delivered via normal vaginal delivery as was also observed in other parts of Nigeria, [4,5,[16][17][18] India, [11,19] and Iran. [12] Operative deliveries are usually declined by many women especially in the developing countries due to cultural and religious beliefs as well as its huge financial implications.…”

“…The incidence of birth injuries among neonates admitted in the neonatal unit of the Rivers State University Teaching Hospital observed to be 6.9 per 1000 live births was comparable with the 5.7 per 1000 live births documented in Maiduguri, Borno state [5] in northern Nigeria. It was higher than the 3.26 per 1000 live births reported in India [11] and 0.8 per 1000 live births in Iran [12] but lower than the 11 per 1000 live births, 22 per 1000 live births, 22.22 per 1000 live births, 41.16 per 1000 live births, 23.7 per 1000 live births and 29 per 1000 live births in Enugu, [4] southeast Nigeria, Iran, [7,13] India, [8] Finland [14] and the United States. [15] This difference in the incidence rates could be attributed to the varying Vol.8; Issue: 6; June 2021 geographic locations, study designs, variations over time as well as the standard of obstetric practices.…”

“…The incidence rates in Africa ranges from 11-57 per 1000 live births. [3][4][5][6] A study in Iraq [7] recorded an incidence rate of 22 per 1000 and 22.22 per 1000 live births in India. [8] Birth injuries could be as a result of maternal, fetal and delivery factors.…”

“…Studies have shown that there is a higher risk of babies having birth injuries when delivered vaginally compared to a caesarean section delivery. [4][5][6] Instrumental deliveries such as forceps and vacuum deliveries also pose a greater risk of babies having birth injuries. [2] There are different forms of birth injuries.…”