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241 Association of Parity and Previous Birth Outcome With Brachial Plexus Birth Injury Risk

Part of: JCTS_2024_ABSTRACT_COLLECTION

Published online by Cambridge University Press:  03 April 2024

Mary Claire Manske ,
Machelle D. Wilson ,
Barton L. Wise ,
Michelle A. James ,
Joy Melnikow ,
Herman L. Hedriana  and
Daniel J. Tancredi
Mary Claire Manske
Affiliation:
University of California Davis
Machelle D. Wilson
Affiliation:
Principal Biostatistician, Clinical and Translational Science Center, Department of Public Health, Sciences, Division of Biostatistics, University of California Davis, Sacramento, California, United States
Barton L. Wise
Affiliation:
Department of Internal Medicine, University of California Davis, Sacramento, California, United States
Michelle A. James
Affiliation:
Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States; Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California, United States
Joy Melnikow
Affiliation:
Department of Family and Community Medicine, University of California Davis, Sacramento, California, United States
Herman L. Hedriana
Affiliation:
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California Davis, Sacramento, California, United States
Daniel J. Tancredi
Affiliation:
Department of Pediatrics, University of California Davis, Sacramento, California, United States
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Abstract

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OBJECTIVES/GOALS: To evaluate the association of maternal delivery history with a brachial plexus birth injury (BPBI) risk in subsequent deliveries, and to estimate the effect of subsequent delivery method on BPBI risk. METHODS/STUDY POPULATION: We conducted a retrospective cohort study of all livebirth deliveries occurring in California-licensed hospitals from 1996-2012. The primary outcome was recurrent BPBI in a subsequent pregnancy. The exposure was prior delivery history (parity, shoulder dystocia in a previous delivery, or previously delivering an infant with BPBI). Multiple logistic regression was used to model adjusted associations of prior delivery history with BPBI in a subsequent pregnancy. The adjusted risk (AR) and adjusted risk difference (ARD) for BPBI between vaginal and cesarean delivery in subsequent pregnancies were determined, stratified by prior delivery history, and the number of cesarean deliveries needed to prevent one BPBI was determined. RESULTS/ANTICIPATED RESULTS: Of 6,286,324 infants delivered by 4,104,825 individuals, 7,762 (0.12%) were diagnosed with a BPBI. Higher parity was associated with a 5.7% decrease in BPBI risk with each subsequent delivery (aOR 0.94, 95%CI 0.92, 0.97). Previous shoulder dystocia or BPBI were associated with 5-fold (aOR=5.39, 95%CI 4.10, 7.08) and 17-fold increases (aOR=17.22, 95%CI 13.31, 22.27) in BPBI risk, respectively. Among individuals with a history of delivering an infant with a BPBI , cesarean delivery was associated with a 73.0% decrease in BPBI risk (aOR=0.27, 95%CI 0.13, 0.55), compared with an 87.9% decrease in BPBI risk (aOR=0.12, 95%CI 0.10, 0.15) in individuals without this history. Among individuals with a previous history of BPBI, 48.1 cesarean deliveries are needed to prevent one BPBI. DISCUSSION/SIGNIFICANCE: Parity, previous shoulder dystocia, and previously delivering a BPBI infant are associated with future BPBI risk. These factors are identifiable prenatally and can inform discussions with pregnant individuals regarding BPBI risk and planned mode of delivery.

Type
Health Equity and Community Engagement
Information
Journal of Clinical and Translational Science , Volume 8 , Issue s1 , April 2024 , pp. 73
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2024. The Association for Clinical and Translational Science