Predictive Factors for Birth Trauma in Southwestern Nigeria

Abstract

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian
university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used
to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors
predisposing to birth trauma. A total of 137 neonatal hospital admissions with
birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva
haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly
bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section
were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma.

Keywords: Birth Trauma, Predictive factors, Prevalence,
Nigeria.

African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 20-25