American Journal of Obstetrics & Gynecology
Volume 202, Issue 4 , Pages 361.e1-361.e6, April 2010

Route of delivery and neonatal birth trauma

Presented at the District IV Meeting of the American College of Obstetricians and Gynecologists, Orlando, FL, Sept. 5-7, 2008.

  • Charmaine K. Moczygemba, MD

      Affiliations

    • Department of Gynecology and Obstetrics, Emory University, Atlanta, GA
    • Corresponding Author InformationReprints: Charmaine K. Moczygemba, MD, Department of Gynecology and Obstetrics, Emory School of Medicine, 69 Jesse Hill Jr Dr., Fourth Floor, Atlanta, GA 30303
    • ,
  • Pangaja Paramsothy, MPH

      Affiliations

    • Contraceptive Research And Development Program, Arlington, VA
    • ,
  • Susan Meikle, MD, MSPH

      Affiliations

    • Contraceptive and Reproductive Health Branch/National Institutes of Health (the Eunice Kennedy Shriver National Institute of Child Health and Human Development), Bethesda, MD
    • ,
  • Athena P. Kourtis, MD, PhD, MPH

      Affiliations

    • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • Wanda D. Barfield, MD, MPH

      Affiliations

    • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • Elena Kuklina, MD, PhD

      Affiliations

    • Northrop Grumman Civilian Group, Atlanta, GA
    • ,
  • Samuel F. Posner, PhD

      Affiliations

    • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • Maura K. Whiteman, PhD

      Affiliations

    • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • Denise J. Jamieson, MD, MPH

      Affiliations

    • Department of Gynecology and Obstetrics, Emory University, Atlanta, GA
    • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA

Received 9 June 2009; received in revised form 12 September 2009; accepted 14 November 2009. published online 15 January 2010.

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.

Key words: neonatal birth trauma, patient safety, route of delivery

 

 Cite this article as: Moczygemba CK, Paramsothy P, Meikle S, et al. Route of delivery and neonatal birth trauma. Am J Obstet Gynecol 2010;202:361.e1-6.

PII: S0002-9378(09)02215-7

doi:10.1016/j.ajog.2009.11.041

American Journal of Obstetrics & Gynecology
Volume 202, Issue 4 , Pages 361.e1-361.e6, April 2010