Obstetric brachial plexus palsy: incidence, monitoring of progress and prognostic factors
*Correspondencia: Dra. Ana Camacho Salas. Universidad Complutense de Madrid, Madrid, Espana; Hospital Universitario 12 de Octubre, Madrid, Espana.
E-mail: acamachosalas@yahoo.es
Introduction. Obstetric brachial plexus palsy is related with shoulder dystocia, and its main risk factor is macrosomia. Its
incidence is estimated to be between 0.1 and 6.3 cases per 1,000 live newborn infants. Most cases are resolved but can
give rise to permanent functional deficiency, which means that there is an interest to identify possible prognostic factors.
Patients and methods. We conducted a descriptive study of newborn infants with obstetric brachial plexus palsy born in
our hospital between the years 2011 and 2015. Maternal, perinatal and obstetric variables, as well as the type of lesion,
were collected and were related with the possibility of recovery at six months.
Results. Altogether 32 cases were diagnosed, which represents an incidence of 1.44‰ of live newborn infants. 59% were
males and 37.5% of them were macrosomic. The most frequent disorder was injury to the plexus at the proximal level
(94%). 44% suffered from shoulder dystocia, and 47% still had sequelae at the sixth month. The antecedent of shoulder
dystocia was related with a poor prognosis for recovery.
Conclusions. The incidence of obstetric brachial plexus palsy has remained stable in recent years. The percentage of
children who present sequelae at six months is significant. Prospective studies are needed to be able to establish the longterm
prognostic factors of this pathology.
Pacientes y métodos Estudio descriptivo de los recién nacidos con parálisis del plexo braquial obstétrica nacidos en el hospital entre los años 2011 y 2015. Se han recogido variables maternas, perinatales, obstétricas y del tipo de lesión, y se han relacionado con la posibilidad de la recuperación a los seis meses.
Resultados Se diagnosticaron 32 casos, lo que supone una incidencia del 1,44 de recién nacidos vivos. El 59% fueron varones, y el 37,5%, macrosómicos. La afectación más frecuente fue la lesión del plexo a nivel proximal (94%). El 44% sufrió distocia de hombros, y el 47% permaneció con secuelas al sexto mes. El antecedente de distocia de hombros se relacionó con mal pronóstico de recuperación.
Conclusiones La incidencia de parálisis braquial obstétrica se mantiene estable en los últimos años. El porcentaje de niños que presentan secuelas a los seis meses es relevante. Son necesarios estudios prospectivos para poder establecer los factores pronósticos a largo plazo de esta patología.
