Epidemiology of Obstetrical Brachial Plexus Injury

Brachial plexus birth injury (BPBI) remains a source of morbidity and financial burden in the pediatric population. The incidence of BPBI has been estimated between 1.6 and 5.1 per 1000 live births. Risk factors include shoulder dystocia, fetal macrosomia (>4500 g), a previous child with shoulder dystocia or BPBI, maternal diabetes, assisted vaginal delivery, multiparity, prolonged labor, excessive maternal weight gain, and fetal malposition. Prevention of BPBI remains a challenge, as not all infants diagnosed with BPBI had identifiable risk factors. Cesarean delivery and induction of labor have been shown to be protective against BPBI, but their use in prevention should be targeted for patients at the highest risk.