An approach to the prediction of neonatal Erb palsy
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John E. Deaver
Abstract
We devised a method to predict risk of neonatal Erb palsy using variables ascertainable before delivery. Multiple logistic regression modeling was used to construct an Erb palsy risk score from a case-control study of 45 consecutive Erb palsy cases and 90 controls. Receiver-operator characteristics identified a range of scores for which likelihood ratios were determined for calculation of predictive values across a range of prior probabilities. In the final model, large estimated fetal weight, gestational diabetes, large maternal body mass index, large weight gain, and black race were associated with 2.3–4.8 times greater odds of Erb palsy. A long second stage had a modest effect on the odds (OR=2.7, P=0.13), unless preceded by a long deceleration phase, which combination increased the odds of Erb palsy to 20.1 (P=0.001). A risk score of 0.72 had a sensitivity of 36% and a specificity of 99%. In a theoretical population with a birth prevalence of brachial plexus palsy of 2.5/1000, application of the risk score would prevent 36% of cases and result in about 14 cesareans for every nerve injury prevented. We conclude that risk scoring using multiple logistic regression coefficients of variables that can be known in time to affect decision-making about mode of delivery has the potential to guide intervention to prevent some Erb palsies.
©2009 by Walter de Gruyter Berlin New York
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- Congress Calender
- Congress Calendar
- WAPM-Newsletter 1/2009: Istanbul Declaration on following Ethics in Perinatal Medicine
- WAPM-Newsletter No 1/2009
Articles in the same Issue
- Selected articles from the 31st scientific meeting of the New York Perinatal Society on May 19, 2008
- Advanced maternal age as a sole indication for genetic amniocentesis; risk-benefit analysis based on a large database reflecting the current common practice
- Risks for common medical conditions experienced by former preterm infants during toddler years
- Predictors of severe perineal lacerations in Chinese women
- Maternal and neonatal outcomes in early glucose tolerance testing in an obstetric population in New York city
- Original articles – Obstetrics
- Prelabor rupture of membranes at term requiring labor induction – a feature of occult fetal cephalopelvic disproportion?
- Group B Streptococcus colonization in pregnancy: prevalence and prevention strategies of neonatal sepsis
- Preterm labor and bacterial vaginosis-associated bacteria among urban women
- Lipopolysaccharide binding protein in the early diagnosis of intraamniotic infection of pregnant women with premature rupture of the membranes
- Perinatal outcomes after second trimester detection of amniotic fluid viral genome in asymptomatic patients
- Is induced abortion a risk factor in subsequent pregnancy?
- An approach to the prediction of neonatal Erb palsy
- External cephalic version among women with a previous cesarean delivery: report on 36 cases and review of the literature
- Original articles – Fetus
- Reference range of fetal lung volume by 3D-ultrasonography using the rotational method (VOCAL)
- Sex differences in linear and complex fetal heart rate dynamics of normal and acidemic fetuses in the minutes preceding delivery
- Misidentification of maternal for fetal heart rate patterns after delivery of the first twin
- Original articles – Newborn
- Prevalence and risk factors for hypothermia on admission in Nigerian babies <72 h of age
- Influence of sociodemographic and psychosocial characteristics on breastfeeding duration of mothers attending breastfeeding support groups
- Congress Calender
- Congress Calendar
- WAPM-Newsletter 1/2009: Istanbul Declaration on following Ethics in Perinatal Medicine
- WAPM-Newsletter No 1/2009
