Neonatal birth injuries
- Tiffany M McKee-Garrett, MD
Tiffany M McKee-Garrett, MD
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Leonard E Weisman, MD
Leonard E Weisman, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
- William Phillips, MD
William Phillips, MD
- Section Editor — Pediatric Orthopedics
- Professor of Pediatrics and Orthopedics
- Baylor College of Medicine
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
Birth injury is defined as an impairment of the neonate's body function or structure due to an adverse event that occurred at birth. The overall incidence of birth injuries has declined with improvements in obstetrical care and prenatal diagnosis. The reported incidence of birth injuries is about 2 and 1.1 percent in singleton vaginal deliveries of fetuses in a cephalic position and in cesarean deliveries, respectively [1,2]. Injury may occur during labor, delivery, or after delivery, especially in neonates who require resuscitation in the delivery room.
There is a wide spectrum of birth injuries ranging from minor and self-limited problems (eg, laceration or bruising) to severe injuries that may result in significant neonatal morbidity or mortality (ie, spinal cord injuries).
The risk factors associated with birth trauma and specific birth injuries will be reviewed here.
The following factors that increase the risk of birth injuries may be due to the fetus (eg, fetal size and presentation), the mother (eg, maternal size and the presence of pelvic anomalies), or the use of obstetrical instrumentation during delivery:
●Macrosomia – When the fetal weight exceeds 4000 g, the incidence of birth injuries rises as the fetal size increases. In one study, when compared with normosmic neonates, the incidence of birth injury was twofold greater in infants weighing 4000 to 4499 g, three times greater in those with births weights between 4500 to 4999 g, and 4.5 times greater in those with a birth weight greater than 5000 g . In another study, the incidence of fetal injury was 7.7 percent in infants with birth weights greater than 4500 g .
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- RISK FACTORS
- SOFT TISSUE INJURIES
- Bruising and petechiae
- Subcutaneous fat necrosis
- EXTRACRANIAL INJURIES
- Caput succedaneum
- Subgaleal hemorrhage
- Facial injuries
- - Nasal septal dislocation
- - Ocular injuries
- INTRACRANIAL HEMORRHAGE
- Subdural hemorrhage
- Subarachnoid hemorrhage
- Epidural hemorrhage
- Intraventricular hemorrhage
- Premature infants
- NEUROLOGIC INJURIES
- ABDOMINAL INJURIES
- SUMMARY AND RECOMMENDATIONS