Journal of Childhood & Developmental Disorders

Description

Trauma sustained by newborns during labor is referred to as a birth injury. Birth injuries have only been the subject of a handful of population-based studies. In addition, the reported incidences range widely, from 0.2 to 37 per 1000 births, depending on the study population and the type of birth injury. Minor soft-tissue injuries to potentially fatal intracranial hemorrhages are examples of birth injuries. According to previous research, injuries to the scalp and cephalohaematoma are the most frequently reported birth injuries, with an incidence of up to 20.4 per 1000 births. Following this are clavicle fractures, which occur between 2.4 and 15 times for every 1000 births. These wounds normally recuperate without lingering distortion, and long haul forecast is great. In the meantime, it has been reported that the incidence of more serious and potentially long-lasting trauma sequelae, such as injuries to the brachial plexus, ranges from one to 3.5 per 1000 live births. The reported incidence of intracranial hemorrhages ranges from 0.1 to 1.4 per 1000 live births. Birth injuries are linked to the method of birth and birth weight. Several of the risk factors for birth injuries have changed in Finland. For instance, there has been a decline in the number of newborns born with a birthweight of over 4000 g, but pregnant women tend to be older, more obese, and there has been an increase in the prevalence of gestational diabetes and induced labor. We hypothesized that the overall incidence of birth injuries may have increased throughout the study period in light of these demographic shifts. The purpose of this study was to determine whether there were any changes in the incidence of all birth injuries in Finland between 1997 and 2017. It also sought to assess the population-based incidences of birth injuries. In addition, the objective of the study was to describe the distribution of birth injuries across the various gestational weeks.

The study included a total of 1 203 434 live-born neonates. The number of annual births was derived from the statutory, computer-based national Medical Birth Register (MBR), and the codes for birth injuries were based on the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The MBR was established in Finland in 1987 and contains information on every single live birth and stillbirths with a birthweight of something like 500 g or a development period of no less than 22 + 0 weeks. All infants born in or out of the hospital are included in the MBR's data. Data are collected twice during the first week of life, once by a midwife after delivery and once by a paediatrician before discharge, as per standard procedure. Demographic characteristics, maternal characteristics, reproductive history, adverse pregnancy and delivery outcomes, delivery statistics, neonatal data, infant health outcomes, and infant diagnosis up to the age of seven days, or at discharge if earlier, are included in the collected data. The information of the MBR are supplemented by data from the Focal Populace Register and Reasons for death information from Measurements Finland. In terms of the database's coverage and accuracy, the MBR has excellent validity. To expand the inclusion of our information past 7 days after birth, we additionally incorporated all emergency clinic visits with any birth injury analysis (either long term or short term) that were recorded into the Consideration Register for Medical care during the main year after birth. Also a statutory computer-based administrative register, the Care Register for Health Care is a continuation of the previous Hospital Discharge Register. It contains patient characteristics like age, sex, primary and secondary diagnosis, and all operations performed during the hospital stay. The Care Register for Health Care has been shown to have good coverage and accuracy.

Incidence of Birth Injury

In most cases, the diagnosis of the birth injury is made through clinical examination after the delivery. However, a radiologic evaluation is carried out if there is a suspicion of longbone (except clavicle) fractures or serious extracranial or intracranial hemorrhage. A hand surgeon or a paediatric surgeon examines a newborn who is suspected of having Erb paralysis or a long-bone fracture. At birth, within the first seven days of life, or during the first year of life, the following birth injury codes (ICD-10) were identified: intracranial laceration and hemorrhage as a result of a birth injury (P10), as well as other birth injuries to the central nervous system (P11), the scalp (P12), the skeleton (P13), and the peripheral nervous system (P14).

Between 1997 and 2017, this study looked at the prevalence and temporal trends of birth injuries in Finland. The primary finding of this study was that over the course of 21 years, the overall incidence of birth injuries in live births decreased by half, from 34.0 per 1000 live births to 16.6. The decrease in clavicle fractures was primarily to blame for this decrease. There were 23.7 birth injuries per 1000 live births overall. Clavicle fracture, cephalohaematoma, and Erb paralysis were the most common injuries. Term pregnancies had the highest injury rates.

Gestation Age

Birth injuries have only been the subject of a handful of population-based studies. The total birth injury rate in this study was approximately 29 per 1000 births, which was comparable to the rate reported in previous studies. Also, other studies have said that the rate of severe and total birth injuries has gone down or stayed the same. All birth injuries, even minor ones, that were reported were included in this study. Compared to Tomaschek et al.'s previous study, which found a decrease of 21% and a lowest incidence of 29 per 1000 live births, our study's total birth injuries decreased by 51%.

A decrease in the number of clavicle fractures was responsible for the majority of the decline in birth injuries. During the course of the study, the rate dropped from 17.4 to 5.0 per 1000 live births. The incidence has ranged from 2.0 to 18 per 1000 births in previous studies. Erb paralysis decreased in tandem with a decrease in the number of clavicle fractures. During the course of the study, the prevalence of Erb paralysis and brachial plexus injury decreased to 1.8 and 1.6 per 1000 live births, respectively, respectively. The rate of injury to the brachial plexus was in line with what was found in previous studies. A clavicle fracture and plexus injury are frequently associated with shoulder dystocia. The fact that clavicle fractures and plexus injuries are occurring at lower rates suggests that shoulder dystocia is becoming less common or that its management has improved over time.