Retrospective evaluation of our patients with neonatal brachial plexus palsy birth injury

Objective: We aimed to obtain information about the demographic characteristics, risk factors, clinical classification, treatment requirements and treatment results of patients who were followed up with the diagnosis of neonatal brachial plexus palsy between January 2011 and December 2021 in the Pediatric Neurology and Physical Medicine and Rehabilitation Outpatient Clinic of Çukurova University Faculty of Medicine Balcalı Hospital. Method: 79 patients were included in the study. Consent was obtained from the families of all patients. Data were collected from patient files for age, gender, type of birth, birth weight, place of birth, palsy side of body, age at admission to hospital for treatment, accompanying problems, type of palsy (according to Narakas classification), and treatment methods. Results: Of our 79 patients in our study, 57% were girls. 91.1% of the patients were born with vaginal delivery, and 81% of them were admitted to the hospital in the first trimester. Mean birth weights were 3987.57 ±528.424 grams, and 58.2% were born 4000 grams or more. According to the Narakas clinical classification; We had 39% of patients in Group 1, 30% in Group 2, 27% in Group 3 and 4% in Group 4. Neonatal brachial plexus palsy was on the right side in 74.7% of the patients. 24.1% of the patients were detected with accompanying additional problems. Among the risk factors related to baby, mother and delivery, the presence of gestational diabetes in the mother and prolonged labour were found to be significantly related to Narakas clinical classification (p<0.05). It was determined that 74.7% of our patients had electromyography and 37% of these patients had more than one electromyography. (p=0.002) 98.7% of our patients received physiotherapy, 73% received physiotherapy in the first 3 months, and average. The duration of physiotherapy was 36.71±36.34 months. It was found that 16% of our patients underwent surgical treatment and the mean age of surgical treatment was 6.07±3.54 years. When the treatment results were evaluated, there was complete recovery in 32% of our patients, partial recovery in 52% of our patients, and no improvement in 16% of our patients. Conclusion: In our study, a higher rate of total brachial plexus paralysis was seen in our patients who had babies of mothers with gestational diabetes. however, prolonged birth history was found to have a borderline significant relationship with the Narakas clinical classification. The risk factors present in our patients were determined as high birth weight, breech presentation, advanced maternal age, maternal excessive weight gain, maternal uterine anomaly, shoulder dystocia, and assisted device birth. No significant correlation was found between the Narakas clinical classification of these risk factors. It is important to know and recognize the risk factors in the literature and to be more careful in cases where more than one risk factor is associated. There is a need for additional studies such as the incidence in recent years in our country, determining its one-to-one relationship with risk factors, and finding ideal and highly specific imaging methods.