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95 Maternal Epidemiology of Brachial Plexus Birth Injuries in California: 1996-2012

Published online by Cambridge University Press:  03 April 2024

Mary Claire Manske
Affiliation:
University of California Davis
Machelle D. Wilson
Affiliation:
Principal Biostatistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, California, United States
Barton L. Wise
Affiliation:
Professor, Department of Internal Medicine, University of California Davis, Sacramento, California, United States
Joy Melnikow
Affiliation:
Professor Emeritus, Department of Family and Community Medicine, University of California Davis, Sacramento, California, United States
Herman L. Hedriana
Affiliation:
Professor and Chief, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine University of California Davis, Sacramento, California, United States
Michelle A. James
Affiliation:
Professor, Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California, United States
Daniel J. Tancredi
Affiliation:
Professor in Residence, Department of Pediatrics, University of California Davis, Sacramento, California, United States
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Abstract

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OBJECTIVES/GOALS: To evaluate the incidence of brachial plexus birth injury (BPBI) and its associations with maternal demographic factors. Additionally, we sought to determine whether longitudinal changes in BPBI incidence differed by maternal demographics. METHODS/STUDY POPULATION: We conducted a retrospective cohort study of over 8 million maternal-infant pairs using California’s Office of Statewide Health Planning and Development Linked Birth Files from 1991-2012. Descriptive statistics were used to determine BPBI incidence and the prevalence of maternal demographic factors (race, ethnicity, age). Multivariable logistic regression was used to determine associations of year, maternal race, ethnicity, and age with BPBI. Excess population level risk associated with these characteristics was determined by calculating population attributable fractions. RESULTS/ANTICIPATED RESULTS: The incidence of BPBI between 1991-2012 was 1.28 per 1000 live births, with peak incidence of 1.84 per 1000 in 1998 and low of 0.9 per 1000 in 2008. Incidence varied by demographic group, with infants of Black (1.78 per 1000) and Hispanic (1.34 per 1000) mothers having the highest incidences. Controlling for relevant covariates, infants of Black (AOR=1.88, 95% CI 1.70, 2.08), Hispanic (AOR=1.25, 95% CI 1.18, 1.32) and advanced-age mothers (AOR=1.16, 95% CI 1.09, 1.25) were at increased risk. Disparities in risk experienced by Black, Hispanic, and advanced-age mothers contributed to a 5%, 10%, and 2% excess risk at the population level, respectively. Longitudinal trends in incidence did not vary among demographic groups. Population-level changes in maternal demographics did not explain changes in incidence over time. DISCUSSION/SIGNIFICANCE: Although BPBI incidence has decreased in California, demographic disparities exist. Infants of Black, Hispanic, and advanced-age mothers are at increased BPBI risk compared to White, Non-Hispanic, and younger mothers.

Type
Diversity, Equity, Inclusion and Accessibility
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2024. The Association for Clinical and Translational Science