Route of delivery and neonatal birth trauma

• Published in: American journal of obstetrics and gynecology Vol. 202; no. 4; pp. 361.e1 - 361.e6
• Main Authors: Moczygemba, Charmaine K., MD, Paramsothy, Pangaja, MPH, Meikle, Susan, MD, MSPH, Kourtis, Athena P., MD, PhD, MPH, Barfield, Wanda D., MD, MPH, Kuklina, Elena, MD, PhD, Posner, Samuel F., PhD, Whiteman, Maura K., PhD, Jamieson, Denise J., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.04.2010
• Subjects: Birth Injuries - epidemiology; Birth Weight; Cesarean Section - adverse effects; Cesarean Section - statistics & numerical data; Delivery, Obstetric - adverse effects; Delivery, Obstetric - statistics & numerical data; Female; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Male; neonatal birth trauma; Obstetrics and Gynecology; Parturition; patient safety; Pregnancy; Risk Factors; route of delivery; United States - epidemiology; United States; neonatal birth trauma; patient safety; route of delivery
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2009.11.041

Objective We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery. Study Design Data on singleton infants were obtained from the 2004-2005 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Results The rates of Agency for Healthcare Research and Quality PSI and all birth trauma were 2.45 and 25.85 per 1000 births, respectively. Compared with vaginal, cesarean delivery was associated with increased odds of PSI birth trauma (odds ratio [OR], 1.71), primarily due to an increased risk for “other specified birth trauma” (OR, 2.61). Conversely, cesarean delivery was associated with decreased odds of all birth trauma (OR, 0.55), due to decreased odds of clavicle fractures (OR, 0.07), brachial plexus (OR, 0.10), and scalp injuries (OR, 0.55). Conclusion Infants delivered by cesarean are at risk for different types of birth trauma from infants delivered vaginally.